Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2011; 3(9): 128-130
Published online Sep 15, 2011. doi: 10.4251/wjgo.v3.i9.128
Are we jumping the gun with pharmaconutrition (immunonutrition) in gastrointestinal onoclogical surgery?
Emma Jane Osland, Muhammed Ashraf Memon
Emma Jane Osland, Department of Nutrition, Ipswich Hospital, Ipswich, QLD 4305, Australia
Muhammed Ashraf Memon, Department of Surgery, University of Queensland, Brisbane, QLD 4072, Australia
Muhammed Ashraf Memon, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia
Muhammed Ashraf Memon, Faculty of Health and Social Sciences, University of Bolton, Bolton, Lancashire, BL3 5AB, United Kingdom
Author contributions: All authors were involved in drafting the manuscript and revising it critically for important intellectual content; furthermore, all authors have participated sufficiently in the work to take public responsibility for its content.
Correspondence to: Muhammed Ashraf Memon, FRCS, FRACS, Professor, McCullough Centre, Suite 9, 259 McCullough Street, Sunnybank, QLD 4109, Australia. mmemon@yahoo.com
Telephone: +61-448614170 Fax: +61-7-38101592
Received: April 19, 2011
Revised: August 21, 2011
Accepted: August 26, 2011
Published online: September 15, 2011

Over the last 20 years there has been considerable research into the use of immunonutrition, also referred to as pharmaconutrition, in the management of patients undergoing and recovering from elective gastrointestinal surgery for malignancy. In this group of patients, the use of pharmaconutrition seems to confer superior outcomes to standard nutrition formulations with regards to postoperative infective complications and length of hospital stay. It is therefore frequently recommended for use in elective gastrointestinal oncological surgical populations. However, it remains unclear whether the data supporting these recommendation is robust. Studies reporting improved outcomes with pharmaconutrition frequently compare this intervention with non-equivalent control groups, do not report on the actual nutritional provision received by study participants, overlook the potential impact of industry funding on the conduct of research and do not adopt a multi-disciplinary approach to the research undertaken. For these reasons, an urgent critical re-appraisal of the use and recommendations of pharmaconutrition in this group of patients is warranted to resolve some of the above mentioned issues.

Keywords: Pharmaconutrition, Immunonutrition, Arginine, Gastrointestinal malignancy, Elective surgery