P1.133. Strengthening the Host Before Surgery: Role of Immunonutrition in Esophagectomy for Esophageal Cancer
TL;DR
Preoperative immunonutrition supplementation in patients undergoing esophagectomy for squamous cell carcinoma significantly reduced postoperative infective complications, particularly pneumonia, and improved early nutritional recovery, which support the routine use of immunonutrition in the perioperative management of esophageal cancer patients.
Abstract
Esophageal Cancer: Other Esophageal cancer commonly presents with dysphagia and malnutrition. Esophagectomy following neoadjuvant chemoradiation is the standard treatment for locally advanced disease but is associated with significant postoperative morbidity. Immunonutrition may improve immune response and reduce postoperative complications. This prospective comparative study included 36 patients with squamous cell carcinoma of the esophagus who underwent neoadjuvant chemoradiation followed by esophagectomy with conduit formation. Eighteen patients received preoperative immunonutrition supplementation for seven days in addition to standard diet, while outcomes were compared with 18 previously operated patients who received standard nutrition alone under similar perioperative conditions. Postoperative nutritional parameters, inflammatory markers, infective and non-infective complications, length of hospital stay, and mortality were analyzedto assess the impact of immunonutrition. Patients receiving immunonutrition demonstrated a faster postoperative rise in serum albumin levels, though the overall trend was not statistically significant. A significant reduction in postoperative C-reactive protein levels was observed in the immunonutrition group. Pneumonia occurred in 22.2% of patients receiving immunonutrition compared to 61.1% in the standard nutrition group (p = 0.018). The incidence of anastomotic leak, conduit necrosis, and duration of hospital stay were lower in the immunonutrition group but did not reach statistical significance. No significant difference was observed in other complications or mortality. Preoperative immunonutrition supplementation in patients undergoing esophagectomy for squamous cell carcinoma significantly reduced postoperative infective complications, particularly pneumonia, and improved early nutritional recovery. These findings support the routine use of immunonutrition in the perioperative management of esophageal cancer patients to enhance short-term outcomes.