Immunometabolism, colorectal surgery, insulin resistance, sarcopenia, malnutrition, gut microbiota, postoperative complications, ERAS, immunonutrition, surgical outcomes
DOI:
https://doi.org/10.64784/192Keywords:
Trauma, systemic inflammatory response, neuroendocrine response, immune dysregulation, cytokines, coagulopathy, endothelial dysfunction, mitochondrial dysfunction, metabolic response, recovery trajectoriesAbstract
Immunometabolism has emerged as a key determinant of postoperative outcomes in patients undergoing colorectal surgery, integrating metabolic regulation with immune system function during the perioperative period. Surgical stress induces complex metabolic and inflammatory responses that may become maladaptive in patients with preexisting conditions such as insulin resistance, diabetes mellitus, malnutrition, or sarcopenia. These alterations significantly influence immune competence, tissue repair, and overall recovery. This review analyzes current evidence on the role of immunometabolism in shaping postoperative outcomes, focusing on metabolic status, immune response, nutritional condition, gut microbiota, and perioperative care strategies. The findings highlight that patients with metabolic dysregulation present higher rates of complications, including infections, anastomotic leakage, and prolonged hospital stay. Conversely, interventions such as Enhanced Recovery After Surgery (ERAS) protocols and immunonutrition contribute to improved outcomes by modulating metabolic and inflammatory pathways.
Additionally, the gut microbiota is identified as a critical factor influencing immunometabolic balance, particularly in colorectal surgery, where intestinal integrity plays a central role. The integration of these elements supports a multidimensional and personalized approach to surgical care.
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