Liu LZ, Wei MF, Sun LT, Zhou XL, Guo KB. Letter to the Editor: Practical considerations for continuity and precision in perioperative nutritional management. World J Gastrointest Oncol 2026; 18(10): 120243 [DOI: 10.4251/wjgo.120243]
Corresponding Author of This Article
Kai-Bo Guo, PhD, Department of Oncology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. guokaibo@zcmu.edu.cn
Research Domain of This Article
Oncology
Article-Type of This Article
letter
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Liu LZ, Wei MF, Sun LT, Zhou XL, Guo KB. Letter to the Editor: Practical considerations for continuity and precision in perioperative nutritional management. World J Gastrointest Oncol 2026; 18(10): 120243 [DOI: 10.4251/wjgo.120243]
Li-Zhen Liu, Meng-Fan Wei, School of Medical Technology and Information Engineering, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Lei-Tao Sun, Zhejiang Provincial Hospital of Chinese Medicine, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310006, Zhejiang Province, China
Xin-Lei Zhou, The Third Clinical Medical School, The Rehabilitation Medical School, Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang Province, China
Kai-Bo Guo, Department of Oncology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, Hangzhou 310006, Zhejiang Province, China
Co-first authors: Li-Zhen Liu and Meng-Fan Wei.
Co-corresponding authors: Xin-Lei Zhou and Kai-Bo Guo.
Author contributions: Liu LZ and Wei MF contribute equally to this study as co-first authors; Guo KB and Zhou XL contribute equally to this study as co-corresponding authors; Liu LZ wrote this article; Wei MF handled literature search and referencing; Sun LT provided research guidance.
Supported by Zhejiang Provincial Science and Technology Program for Traditional Chinese Medicine, No. 2024ZL712; and Innovation and Entrepreneurship Project of College Students in Zhejiang Province, No. S202510344061.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Kai-Bo Guo, PhD, Department of Oncology, Affiliated Hangzhou First People’s Hospital, School of Medicine, Westlake University, No. 261 Huansha Road, Hangzhou 310006, Zhejiang Province, China. guokaibo@zcmu.edu.cn
Received: February 24, 2026 Revised: March 10, 2026 Accepted: April 15, 2026 Published online: October 15, 2026 Processing time: 207 Days and 23.8 Hours
Abstract
It is our assertion that the combination of the PIPOST framework and early enteral nutrition (EEN) provides a strong basis for the nutritional management of perioperative patients. There are some practical tweaks, though, which could enhance its clinical impact. The clinical utility and scalability of the framework may be further enhanced through integrating biologically informed and data driven support throughout the entire perioperative period as well as tailoring interventions to the characteristics of different patient subgroups. Based on the latest work of Chang et al in the World Journal of Gastrointestinal Oncology, who show that PIPOST-EEN is useful in colorectal cancer surgery. We present these thoughts as constructive considerations to further develop this model and to ensure more widespread application of the model.
Core Tip: The integrated PIPOST framework and early enteral nutrition framework will be enhanced as per this letter. This model may evolve from a static protocol into a more adaptive and personalized clinical decision-support system for perioperative nutritional management by incorporating dynamic biomarkers, extending care across the entire perioperative continuum, and prioritizing validation in vulnerable patient subgroups.
