Effects of 3 Day Preoperative Immunonutrition in Well-nourished Patients With Gastrointestinal (GI) Cancer Undergoing Surgery (IPOD-3)

Inclusion Criteria:

• Patients with GI cancer (stomach, pancreas, small and large bowel and rectum) histologically proven
• Well nourished patients as defined by a total score of <3 on the nutritional screening tool NRS-2002 (46) (Appendix III)
• Patients who are >= 18 years of age;
• Patients who have signed a written Informed Consent (Appendix I) prior to admission to the study;
• Patients who have an ECOG performance status of 0, 1 or 2 (Appendix II).
• Patients able to orally consume 750 mL or more of liquid a day prior to surgery

Exclusion Criteria:

• Patients who have co-morbid conditions, uncontrolled metabolic conditions or psychiatric conditions that might make tolerance or evaluation of the feeding formula difficult;
• Patients who are pregnant;
• Patients with cardiac failure as defined by the Goldman classification class>3
• Patients with respiratory failure (FEV<0.8l/sec)
• Patients with renal failure (Cr >= 3mg/dl or dialysis patients)
• Patients with hepatic dysfunction (Child >A)
• Patients suffering from an intestinal obstruction or ileum
• Patients with an Hb level of <=8 g/dL experiencing gastrointestinal hemorrhaging
• Patients with HIV, HCV, HBV
• Patients requiring immunosuppression treatments
• Patients undergoing emergency surgery
• Other patients determined by a study investigator to be inappropriate for enrolment in this study