Role of immune nutrients in postoperative outcome in patients undergoing gastrointestinal anastomosis

Background and aims: The science of immunonutrition involves enhancing immunity through macro or micronutrients. The present study aims to determine whether postoperative immunonutrition could improve the clinical outcomes in a patient undergoing gastrointestinal anastomosis. Materials and methods: The hospital-based prospective interventional study involved patients undergoing emergency hand-sewn gastrointestinal anastomosis from July 2021 to August 2022, in the department of General Surgery. The sample was selected using systematic random sampling. Every 4th patient was included in the control group and treated with a conventional approach, while every 5th patient was given immunonutrition in the postoperative period and included in the intervention group. Written informed consent was taken from all the participants. Various postoperative parameters were studied and compared between the two groups using appropriate significance tests. A p-value<0.05 is significant. Results: The rates of reduction in the anastomotic leak, wound infection and mean hospital stay in the intervention vs control group were 10% vs 32% (p-value<0.05), 12.5% vs 35% (p-value<0.05) and 8 days vs 10 days (p-value<0.05) respectively. The mean postoperative day-2 and day-6 serum albumin levels in control vs intervention groups were 3.04mg/dl vs 3.47 mg/dl (p-value<0.05) and 3.02mg/dl vs 3.64mg/dl (p-value<0.05), respectively. Conclusion: The study showed a substantial reduction in rates of anastomotic leak, postoperative infections and length of hospital stay following administration of immunonutrition formula with glutamine, arginine, omega-3 fatty acids and nucleotides in postoperative patients undergoing gastrointestinal anastomosis. 
Keywords: Immunonutrition; glutamine; arginine; omega-3 fatty acids; postoperative complications.