{
  "abstract": "Background/Objectives: Perioperative immunonutrition (IMN) has been proposed to improve outcomes after colorectal surgery. However, the evidence is heterogeneous, and few studies have assessed morbidity together with computed tomography (CT)-derived body composition. We compared IMN with standard oral nutritional supplementation (SONS) in patients undergoing colorectal cancer surgery, evaluating postoperative complications and changes in body composition. Methods: Two-arm open-label randomized clinical trial including sixty patients (SONS: n = 30; IMN: n = 30). Postoperative complications were assessed using the Clavien–Dindo classification, and the Comprehensive Complication Index (CCI). Body composition was quantified using pre- and postoperative CT scans, analyzing the skeletal muscle mass index (SMMI) and psoas area. Results: Baseline characteristics were comparable between groups, except for a higher age in the IMN group (p = 0.036). Overall morbidity was 40% in SONS and 50% in IMN (95%CI: −0.35 to 0.15). No differences were observed in the CCI (14.8 ± 23.1 vs. 15.7 ± 19.0, 95%CI: −11.8 to 10.0). Very major morbidity (Clavien ≥ IIIb) was comparable between groups (p = 0.687). At follow-up there was a decline in handgrip strength in SONS whereas it remained stable in IMN (p = 0.030 for the interaction). Also, there was a decrease in SMMI (−2.33, 95%CI: −1.19 to −3.48 cm2/m2) and psoas area (−1.15, 95%CI: −0.67 to −1.65 cm2) in SONS, whereas in IMN they remained stable: SMMI (−1.48, 95%CI: 1.04 to −3.99 cm2/m2), psoas area (−0.71, 95%CI: 0.36 to 1.78 cm2). Conclusions: IMN did not reduce morbidity compared with SONS when used as prehabilitation for colorectal cancer surgery. Exploratory findings suggested a possible attenuation of postoperative muscle loss with IMN.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain",
    "Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), 28034 Madrid, Spain",
    "Department of General and Digestive Surgery, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain",
    "Department of Medicine, Universidad de Alcalá (UAH), 28801 Alcalá de Henares, Spain",
    "Department of Anesthesiology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain",
    "Department of Radiology, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Beatriz Ugalde"
    },
    {
      "affs": [
        1,
        2,
        3
      ],
      "name": "Luz Juez",
      "orcid": "0000-0002-8287-9711"
    },
    {
      "affs": [
        4
      ],
      "name": "Isabel Ruiz-Torres",
      "orcid": "0000-0002-7577-4380"
    },
    {
      "affs": [
        2
      ],
      "name": "Inés Perea-Fuentes"
    },
    {
      "affs": [
        2
      ],
      "name": "Sara Martos"
    },
    {
      "affs": [
        2
      ],
      "name": "Irene DeVicente"
    },
    {
      "affs": [
        1
      ],
      "name": "Daniel Melero",
      "orcid": "0009-0004-0386-8590"
    },
    {
      "affs": [
        1,
        5
      ],
      "name": "Javier Blázquez"
    },
    {
      "affs": [
        0,
        1,
        3
      ],
      "name": "José Botella-Carretero",
      "orcid": "0000-0002-6425-2747"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/af6g2hvkmmhjc.bib",
  "cited_by": 0,
  "doi": "10.3390/nu18203381",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13708681/?tool=EBI",
  "id": "af6g2hvkmmhjc",
  "issns": [
    "2072-6643"
  ],
  "landing_url": "https://www.mdpi.com/2072-6643/18/20/3381",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Enhanced Recovery After Surgery"
    ]
  ],
  "openalex": "W7222152628",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13708681/pdf/?tool=EBI",
  "pmcid": "PMC13708681",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/af6g2hvkmmhjc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:56Z",
      "native_id": "10.3390/nu18203381",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6643/18/20/3381"
    },
    {
      "first_seen": "2026-10-30T12:21:47Z",
      "native_id": "PMC:PMC13708681",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13708681"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Enhanced Recovery After Surgery",
      "subfield": "surgery"
    }
  ],
  "title": "Immunonutrition vs. Standard Oral Nutritional Supplements in Prehabilitation for Colorectal Cancer Surgery: A Randomized Clinical Trial Assessing Morbidity and Body Composition by Computed Tomography",
  "title_text": "Immunonutrition vs. Standard Oral Nutritional Supplements in Prehabilitation for Colorectal Cancer Surgery: A Randomized Clinical Trial Assessing Morbidity and Body Composition by Computed Tomography",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:47Z",
  "url": "https://research.draconitic.com/paper/af6g2hvkmmhjc",
  "venue": "Nutrients",
  "versions": []
}