Patients with upper gastrointestinal cancer or other surgical diseases are
at high risk for both mechanical and infectious complications. The disease
process itself places these patients at increased risk for malnutrition, with
subsequent postoperative complications. Because these surgeries are
semielective, a period of time is available to optimize the patient's
condition. There are several trials that suggest preoperative immunonutrition
supplementation improves outcomes and is cost-effective by reducing
complications. However, the most important choice a patient or clinician can
make may well be by whom and where the surgery is performed.
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