Impact of Preoperative Enteral Nutrition on Clinical Outcomes in Malnourished Patients Undergoing Elective Colorectal Cancer Surgery: A Prospective Cohort Study

Background: Malnutrition is a frequent yet often overlooked comorbidity in patients undergoing surgery for colorectal cancer. It is associated with adverse postoperative outcomes, including increased complications, prolonged hospital stay, and elevated mortality. Objective: This study aimed to assess the clinical impact of short-term preoperative enteral nutrition in malnourished patients undergoing elective colorectal cancer surgery. Methods: A prospective cohort study was conducted involving 68 malnourished patients with histologically confirmed stage I–III colorectal cancer. Patients were divided into three groups: Group A (14-day enteral nutrition), Group B (7-day enteral nutrition), and Group C (no supplementation). Nutritional status, laboratory parameters, postoperative complications, transfusion needs, and hospitalization metrics were compared among groups. Results: Group A demonstrated the most favorable outcomes, including significantly fewer postoperative complications such as anastomotic leakage (5.0% vs. 17.9%, p = 0.030), reduced transfusion and albumin requirements, and shorter ICU and hospital stays (1.6 ± 0.7 and 7.1 ± 2.4 days, respectively). Group C showed the highest complication and mortality rates. Improvements in biochemical markers were observed in both intervention groups, supporting the efficacy of enteral supplementation. Conclusion: Short-term preoperative enteral nutrition significantly improves clinical outcomes in malnourished colorectal cancer patients undergoing elective surgery. These findings support the integration of nutritional screening and intervention as standard components of perioperative care in oncologic surgery.