Evidence map›Paper›PMID 39904123›Full record

ArticleSurgery2025

Association of perioperative immunonutrition with anastomotic leak among patients undergoing elective colorectal surgery within a robust enhanced recovery after surgery program.

Samuel A Younan, Danish Ali, Alexander T Hawkins, Joel F Bradley, M Benjamin Hopkins, Timothy Geiger, Jennifer Jayaram, Aimal Khan

Abstract read
In one paragraph

Article in Surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Samuel A YounanSection of Colon & Rectal Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, TN.
Danish AliSection of Colon & Rectal Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, TN.
Alexander T HawkinsSection of Colon & Rectal Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, TN.
Joel F BradleyDepartment of Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, TN.
M Benjamin HopkinsSection of Colon & Rectal Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, TN.
Timothy GeigerSection of Colon & Rectal Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, TN.
Jennifer JayaramDepartment of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN.
Aimal KhanSection of Colon & Rectal Surgery, Division of General Surgery, Vanderbilt University Medical Center, Nashville, TN. Electronic address: aimal.khan@vumc.org.

Funding

TRAINING IN GASTROENTEROLOGYT32DK007673 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI RICHARD M. PEEK · 1992 to 2026
$8.4M
Creation and Testing of an Education Decision Aid for Colectomy in Recurrent DiverticulitisR03DK129559 · NIDDK · VANDERBILT UNIVERSITY MEDICAL CENTER · PI HAWKINS, ALEXANDER THARRINGTON · 2022 to 2023
$260k
NIDDK NIH HHS R03 DK129559NIDDK NIH HHS T32 DK007673
6 · The paper itself

Abstract

backgroundImmunonutrition supplementation has been shown to reduce the risk of surgical infectious complications; however, its effect on decreasing anastomotic leak rates, in the context of an otherwise robust Enhanced Recovery After Surgery (ERAS) program, remains unclear. This study aims to assess the association between perioperative immunonutrition supplementation and anastomotic leak in an elective Enhanced Recovery After Surgery colorectal surgical population.

methodsWe performed a retrospective single-institution cohort study consisting of adult patients enrolled in an Enhanced Recovery After Surgery pathway and undergoing elective colorectal surgery from 2018 to 2023. Immunonutrition supplementation was defined as a 10-day perioperative supply of commercially available nutritional shakes. Relevant demographic covariates, preoperative characteristics, and operative methods were identified and analyzed. Multivariable logistic regression was performed to determine the association of immunonutrition with anastomotic leak.

resultsA total of 708 patients were included in the study, of which n = 400 (56.5%) received perioperative immunonutrition. Patients who received immunonutrition were more likely to be older (median age 57.9 vs 55.7), male (52.7% vs 44.8%), have a higher body mass index (27.7 vs 26.3), and less likely to be current smokers (9.8% vs 16.2%). On adjusted analysis, there was no association between immunonutrition use and anastomotic leak (odds ratio = 0.96, 95% confidence interval = 0.45, 2.08), 30-day readmission (odds ratio = 0.97, 95% confidence interval = 0.60, 1.57), or length of stay (β = .40, 95% confidence interval = -0.06, 0.86)

conclusionWe did not observe an association between perioperative immunonutrition supplementation and postoperative anastomotic leak, suggesting that the role of immunonutrition within a comprehensive Enhanced Recovery After Surgery program for elective colorectal surgery may warrant further evaluation.

Indexed as

Anastomotic LeakElective Surgical ProceduresEnhanced Recovery After SurgeryPerioperative CareAdultAgedFemaleHumansImmunonutrition DietLength of StayMaleMiddle AgedRetrospective StudiesRisk Factors

Identifiers

PMID39904123
PMCPMC13109848

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.