抄録
Nutritional management for surgery patients is recognized as an important preventive step against postoperative complications. Immunonutrition is a nutritional approach that can control the immune system by modifying the release of mediators from immune cells and attenuating tissue and organ damage through the administration of specific nutrients. Recently, it has been a challenge to not only supplement the shortage of required energy and major nutrients, i.e., carbohydrates, proteins and lipids, but also to control the immune system and inflammatory responses by using immuno-nutrition in critically ill patients and surgical patients. There are a number of immunonutrients, including arginine, glutamine, n-3 poly-unsaturated fatty acids, nucleotides, etc. These substrates have been revealed to up-regulate host immune responses and to control inflammatory responses, and can thus be applied to the clinical benefit and decrease the incidence of postoperative infectious complication and length of hospital stays. In particular, an immune-enhancing diet that includes n-3 poly-unsaturated fatty acids, arginine and nucleotides has been associated with significantly fewer infectious complications in elective gastrointestinal surgical patients. Although some reports have described the effects and application of an immune-enhancing diet in surgical patients, administration of each immunonutrient alone has few clinical benefits. We expect that new immune-enhancing or -modulating diets that can control the host immune response and inflammatory response in surgical stress, will be developed by a combination of adequate immunonutrients.
