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The following is a summary of “Association of perioperative immunonutrition with anastomotic leak among patients undergoing elective colorectal surgery within a robust enhanced recovery after surgery program,” published in the May 2025 issue of Surgery by Younan et al. 

Immunonutrition supplementation has demonstrated benefits in lowering surgical infectious complications, but its role in reducing anastomotic leak rates within a well-established Enhanced Recovery After Surgery (ERAS) program remains uncertain.  

Researchers conducted a retrospective study to analyze the association between perioperative immunonutrition supplementation and anastomotic leak rates in individuals undergoing elective colorectal surgery within an ERAS program.  

They included adults who underwent elective colorectal surgery within an ERAS pathway from 2018 to 2023. Immunonutrition was defined as a 10-day perioperative course of commercially available nutritional shakes. Demographic data, preoperative factors, and surgical approaches were collected and analyzed. Multivariable logistic regression was used to evaluate the association between immunonutrition and anastomotic leak.  

The results showed that 708 individuals were included, with 400 (56.5%) receiving perioperative immunonutrition. Those given immunonutrition were older (median age 57.9 vs 55.7 years), more often male (52.7% vs 44.8%), had higher body mass index (27.7 vs 26.3), and fewer were current smokers (9.8% vs. 16.2%). Adjusted analysis indicated no significant link between immunonutrition and anastomotic leak (odds ratio = 0.96, 95% CI = 0.45, 2.08), 30-day readmission (odds ratio = 0.97, 95% CI = 0.60, 1.57), or hospital stay duration (β = .40, 95% CI = –0.06, 0.86).  

Investigators concluded that perioperative immunonutrition supplementation was not associated with postoperative anastomotic leak, indicating the need for further investigation of its role within an ERAS program for elective colorectal procedures

Source: surgjournal.com/article/S0039-6060(25)00011-X/fulltext