Evidence map›Paper›PMID 27081153›Full record

ReviewGastroenterology report2016

Should perioperative immunonutrition for elective surgery be the current standard of care?

Shishira Bharadwaj, Brandon Trivax, Parul Tandon, Bilal Alkam, Ibrahim Hanouneh, Ezra Steiger

Registry-linked trialOpen access · diamondAbstract readReview
In one paragraph

Review in Gastroenterology report, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05568316 (Impact of Immunonutrition on Nutritional Status in Patients Undergoing Colorectal Cancer Surgery), which is not on this map. Cited by 14 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
14citing papers in PubMed, 1 pooled it
3.5field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05568316 nacompletednot on this mapstarted 2020, after this paper: background citation

Impact of Immunonutrition on Nutritional Status in Patients Undergoing Colorectal Cancer Surgery: A Randomised Controlled Clinical Trial

TypeinterventionalSponsorSaglik Bilimleri UniversitesiRan2020 to 2022Enrolled50ConditionsColorectal CancerArmsPreoperative Immunonutrition, Perioperative Immunonutrition
3 · Its place in the literature

Who cites it

14 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Prehabilitation and postoperative outcomes in colorectal surgery: an umbrella review.Journal of anesthesia, analgesia and critical care · 2026
    Review
  4. Article
  5. Review
  6. Effects of preoperative immunonutritionWorld journal of gastrointestinal surgery · 2025
    Article
  7. Targeted nutritional strategies in postoperative care.Anesthesia and pain medicine · 2025
    Review
  8. Review
  9. Article
  10. Article
  11. Effect of preoperative immunonutrition on complications after salvage surgery in head and neck cancer.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2019
    Article
  12. The Effect of Immunonutrition on Veterans Undergoing Major Surgery for Gastrointestinal Cancer.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2018
    Article
  13. Article
  14. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Shishira BharadwajCenter for Human Nutrition, the Cleveland Clinic Foundation, Cleveland, OH, USA.
Brandon TrivaxCollege of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.
Parul TandonCollege of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.
Bilal AlkamCenter for Human Nutrition, the Cleveland Clinic Foundation, Cleveland, OH, USA.
Ibrahim HanounehCenter for Human Nutrition, the Cleveland Clinic Foundation, Cleveland, OH, USA.
Ezra SteigerCenter for Human Nutrition, the Cleveland Clinic Foundation, Cleveland, OH, USA steigee@ccf.org.
Cleveland Clinic · USMichigan State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Postoperative infectious complications are independently associated with increased hospital length of stay (LOS) and cost and contribute to significant inpatient morbidity. Many strategies such as avoidance of long periods of preoperative fasting, re-establishment of oral feeding as early as possible after surgery, metabolic control and early mobilization have been used to either prevent or reduce the incidence of postoperative infections. Despite these efforts, it remains a big challenge to our current healthcare system to mitigate the cost of postoperative morbidity. Furthermore, preoperative nutritional status has also been implicated as an independent risk factor for postoperative morbidity. Perioperative nutritional support using enteral and parenteral routes has been shown to decrease postoperative morbidity, especially in high-risk patients. Recently, the role of immunonutrition (IMN) in postoperative infectious complications has been studied extensively. These substrates have been found to positively modulate postsurgical immunosuppression and inflammatory responses. They have also been shown to be cost-effective by decreasing both tpostoperative infectious complications and hospital LOS. In this review, we discuss the postoperative positive outcomes associated with the use of perioperative IMN, their cost-effectiveness, current guidelines and future clinical implications.

Indexed as

cost-effectivenessguidelinesimmunonutritioninfectionspostoperative complications

Identifiers

PMID27081153
PMCPMC4863194
OpenAlexW2339654417

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.