Effects of long-term immunonutrition on postdischarge colorectal cancer surgery patients

doi:10.4240/wjgs.118979

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Randomized Controlled Trial

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Jun 27, 2026; 18(6): 118979
Published online Jun 27, 2026. doi: 10.4240/wjgs.118979

Table 1 Demographics and disease-related data for each cohort, n (%)

Category	*IMN group (n =* 296)**	*No-IMN group (n =* 151)**	P value
Gender			0.911
Male	180 (60.8)	91 (60.3)
Female	116 (39.2)	60 (39.7)
Median age; years (range)	60 (28-75)	59 (30-75)	0.227
≤ 44	15 (6.8)	19 (12.6)
45-59	115 (38.9)	57 (37.7)
60-75	161 (54.3)	75 (49.7)
BMI			0.761
< 18.5	15 (5.1)	4 (2.7)
18.5-23.9	125 (42.2)	71 (47.0)
24-27.9	123 (41.6)	55 (36.4)
≥ 28	33 (11.1)	21 (13.9)
ASA score			0.329
I	36 (12.2)	19 (12.6)
II	192 (64.9)	96 (63.6)
III	62 (20.9)	33 (21.9)
IV	6 (2.0)	3 (1.9)
Tumor site			0.523
Rectum	175 (59.1)	94 (62.3)
Colon	121 (40.9)	57 (37.7)
TNM stage			0.472
Carcinoma in situ	15 (5.1)	8 (5.3)
I-II	145 (49.0)	75 (49.7)
III-IV	136 (45.9)	68 (45.0)
Previous abdominal surgery			0.461
Yes	74 (25.0)	33 (21.9)
No	222 (75.0)	118 (78.1)

BMI: Body mass index; ASA: American Society of Anesthesiology; IMN: Immunonutrition; TNM: Tumor-node-metastasis.

Full Size Table

Table 2 Comparison of nutritional parameters, mean ± SD

Category		IMN group (n = 296)	No-IMN group (n = 151)	P value	95%CI
BMI (kg/m²)	Baseline	22.98 ± 3.14	22.55 ± 2.97	0.306	-0.40 to 1.26
BMI (kg/m²)	Endline	23.45 ± 3.21	23.12 ± 2.94	0.399	-0.43 to 1.08
PG-SGA	Baseline	4.96 ± 2.60	5.41 ± 2.35	0.159	-1.08 to 0.18
PG-SGA	Endline	2.22 ± 1.11	2.65 ± 2.11	0.031^a	-0.04 to 0.82
TFN (mg/L)	Baseline	185.38 ± 38.46	180.86 ± 31.09	0.208	-0.25 to 1.16
TFN (mg/L)	Endline	267.17 ± 49.08	262.4 ± 54.27	0.409	-0.16 to 0.66
ALB (g/L)	Baseline	34.24 ± 3.34	33.67 ± 2.90	0.077	-0.06 to 1.19
ALB (g/L)	Endline	42.23 ± 3.02	41.29 ± 3.08	0.004^a	-0.30 to 1.57
PA (g/L)	Baseline	16.18 ± 4.20	15.65 ± 4.13	0.227	-0.33 to 1.39
PA (g/L)	Endline	27.57 ± 5.80	27.83 ± 5.42	0.736	-1.79 to 1.27
GLU (mmol/L)	Baseline	6.13 ± 1.91	6.07 ± 1.53	0.724	-0.29 to 0.42
GLU (mmol/L)	Endline	5.80 ± 1.28	5.83 ± 1.20	0.847	-0.33 to 0.27

^aP < 0.05.

BMI: Body mass index; PG-SGA: Patient-generated subjective global assessment; TFN: Transferrin; ALB: Albumin; PA: Prealbumin; GLU: Glucose; IMN: Immunonutrition.

Full Size Table

Table 3 Comparison of immunologic parameters, mean ± SD

Category		*IMN group (n =* 296)**	No-IMN group (n = 151)	P value	95%CI
ALC (× 10⁹/L)	Baseline	1.22 ± 0.47	1.16 ± 0.49	0.203	-0.03 to 0.15
ALC (× 10⁹/L)	Endline	1.79 ± 0.60	1.59 ± 0.54	0.001^a	-0.08 to 0.31
CRP (mg/L)	Baseline	5.91 ± 4.73	5.06 ± 4.95	0.077	-0.09 to 1.81
CRP (mg/L)	Endline	1.28 ± 4.51	1.02 ± 3.45	0.543	-0.58 to 1.10
IgG (g/L)	Baseline	8.90 ± 1.85	8.66 ± 1.99	0.222	-0.15 to 0.64
IgG (g/L)	Endline	13.10 ± 2.70	12.24 ± 2.41	0.003^a	-0.29 to 1.42
IgM (g/L)	Baseline	0.82 ± 0.40	0.76 ± 0.37	0.101	-0.01 to 0.15
IgM (g/L)	Endline	1.37 ± 0.48	1.22 ± 0.54	0.007^a	-0.04 to 0.26
IgA (g/L)	Baseline	2.20 ± 0.85	2.08 ± 0.80	0.174	-0.05 to 0.29
IgA (g/L)	Endline	2.94 ± 0.95	2.77 ± 0.74	0.084	-0.02 to 0.36

^aP < 0.05.

IMN: Immunonutrition; ALC: Absolute lymphocyte count; CRP: C-reactive protein; Ig: Immunoglobulin.

Full Size Table

Table 4 Details of postoperative complications and outcomes, n (%)

Category	IMN group (n = 296)	No-IMN group (n = 151)	P value
Infectious complications	28 (9.5)	24 (15.9)	0.045^a
Respiratory tract	3 (1.0)	4 (26)	0.188
Surgical site infection	14 (4.7)	14 (8.2)	0.061
Urinary tract	2 (0.7)	1 (0.7)	0.987
Abdominal abscess	9 (3.0)	5 (3.3)	0.876
Noninfectious	19 (6.4)	8 (5.3)	0.638
Anastomotic fistula	9 (3.0)	4 (2.6)	0.816
Bleeding	2 (0.7)	1 (0.7)	0.987
Intestinal obstruction	4 (1.4)	1 (0.7)	0.512
Wound dehiscence	4 (1.4)	2 (1.3)	0.981
Total incidence of complication	47 (15.9)	32 (21.2)	0.172

^aP < 0.05.

IMN: Immunonutrition.

Full Size Table

Citation: Bao MD, Huang F, Cheng P, Zheng ZX. Effects of long-term immunonutrition on postdischarge colorectal cancer surgery patients. World J Gastrointest Surg 2026; 18(6): 118979
URL: https://www.wjgnet.com/1948-9366/full/v18/i6/118979.htm
DOI: https://dx.doi.org/10.4240/wjgs.118979

Bao MD, Huang F, Cheng P, Zheng ZX. Effects of long-term immunonutrition on postdischarge colorectal cancer surgery patients. World J Gastrointest Surg 2026; 18(6): 118979 [DOI: 10.4240/wjgs.118979]

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