加速康复外科理念是通过优化围手术期处理，减少创伤应激，加速患者康复。良好的营养状况有利于患者减轻 分解代谢，改善临床结局，是加速康复外科的重要组成部分。术前对患者进行常规筛查和评估，对存在营养不良的患者进 行营养干预。但是在判断营养状况的最佳指标或方法上存在一定争议，而且执行情况也不乐观。口服营养补充因其操作方 便、易于管理、并发症少、患者依从性好，已经成为营养干预的首选途径，术前至少持续 7~10 天。术前口服营养补充不但 使术前严重营养不良的患者因此获益，对于术前体重下降的消化系统肿瘤患者，即使没有出现严重的营养不良也可以获益。 尽管免疫营养的作用已被证实，而且围手术期应用免疫营养已成为共识，但是在等氮、等热卡的情况下，术前免疫营养相 对于通用配方营养的优势受到质疑。目前没有免疫营养的最佳组合和配方，而且普通配方制剂也含有一定的免疫营养成分， 所以在术前营养制剂的选择上要根据实际情况而定。

The concept of the enhanced recovery after surgery was to reduce trauma stress and ccelerate patient rehabilitation by optimizing perioperative management. Good nutrition status was conducive for patients to reduce the decomposition metabolism, improve clinical outcome, is an important part of the enhanced recovery after surgery. Preoperative screening and evaluation of patients before operation, and then nutritional intervention in patients with malnutrition was necessary. However, there is some controversy about the best indicators or methods of nutritional status, and implementation was not optimistic. Oral nutritional supplements which was convenient to operation, easy to manage, lower complications, good compliance, was the first choice for nutrition intervention, at least 7 to 10 days before surgery. Preoperative oral nutritional supplements not only benefit patients with severe malnutrition, but also benefit from severe malnutrition in patients with cancer of the digestive system who lost weight before surgery. Although the role of immune nutrition has been confirmed, and the perioperative application of immune nutrition has become consensus, the advantages of preoperative immunonutrition compared to the standard isocaloric and isonitrogenous formula are challenged. At present, there is no optimal combination and formula of immune nutrition, and the preparation of the standard formula also contains certain immunonutritional components, so the selection of preoperative nutritional preparation should be based on the actual situation.