Focusing on nutrition in surgical patients        LI Ning. Research Institute of General Surgery, Nanjing General Hospital of Nanjing Military Command, Medical College of Nanjing University, Nanjing 210002,China
Abstract    Recognition of surgical patients with or at risk of malnutrition remains poor despite the availability of numerous clinical guidelines and clear evidence of the adverse effects of poor nutritional status on postoperative clinical outcomes. The practice of perioperative nutrition support has changed dramatically in the setting of fast-track surgery. In addition, extensive research has clearly shown that modifying the composition of standard nutritional regimen by adding supernormal doses of specific substrates such as arginine, glutamine and omega-3 fatty acid has immuno-modulatory, anti-inflammatory, anabolic and tissue protective ability, which often translates into improved surgical outcome. Therefore, the term “nutritional therapy” instead of “nutrition support” has been increasingly accepted in the era of immunonutrition.