Effect of early postoperative enteral immunonutrition on wound healing in patients undergoing surgery for gastric cancer (original) (raw)
Related papers
Nutrition and cancer, 2018
Immunomodulating enteral nutrition in the perioperative period may reduce postoperative complications in cancer patients. Little is known if this effect translates to the better survival. The aim of study was to assess the impact of postoperative immunomodulating enteral nutrition on postoperative complications and survival of gastric cancer patients. A group of 98 gastric cancer patients was randomly assigned for postoperative immunomodulating enteral nutrition n = 44 (Reconvan, Fresenius Kabi, Bad Homburg, Germany), or standard enteral nutrition n = 54 (Peptisorb, Nutricia, Schipol, The Netherlands). Postoperative complications, mortality, 6-mo and 1-yr survival were analyzed. The overall postoperative morbidity did not differ between the groups. The rate of pulmonary complications (excluding pneumonia) was significantly lower in immunomodulation group (0% vs 9.3%, p = 0.044), as well as 60-day mortality (0% vs. 11.1%, p = 0.037). There was no difference in 6-mo and 1-yr survival ...
Sains Malaysiana
Gastric cancer is one of the most common upper gastrointestinal malignancies. To date, enteral immunonutrition (EIN) has gained increasing attention as it is found to effectively enhance the host's immunity and improve the metabolic status of gastric cancer patients undergoing gastrectomy. The health-boosting effects of EIN are believed to originate from a number of nutritional elements such as omega-3 fatty acids, glutamine, arginine and nucleic acid precursors that help reduce the incidences of post-operative complications and shorten the length of hospital stay among the aforementioned patients. However, little was known about the consistency of health-boosting benefits conferred by EIN. Hence, according to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) protocol, this systematic review was carried out using nine meticulously and specifically selected full-length articles focusing on the pre-and post-operative effects of EIN including physical, biochemical, clinical and immunological outcomes on gastric cancer patients. Among the selected articles, seven of them focused on post-operative EIN while the remaining two concentrated on pre-operative EIN. In most of the selected studies, more than one immunonutritional components (arginine, glutamine, omega-3 fatty acid, RNA) were integrated. Patients receiving EIN showed significantly improved immunity, for example, increase in CD4+ T and NK cell counts that are responsible for fighting pathogens. In addition to that, individuals receiving EIN also showed increased levels of inflammatory biomarkers in their sera such as prealbumin and transferrin. This results in shorter period of post-operative hospital stay that in turn permits progressive healing process and increases the survival rate due to minimal frequency of post-operative infections. Conclusively, our systematic review acknowledges that regardless of the initiation timing (pre-operative or post-operative) of immunonutrition, EIN can improve the overall health status of gastric cancer patients including infection complications and the length of hospital stay through regulation of immune responses.
Scandinavian Journal of Surgery, 2010
Introduction: Current studies suggest immunonutrition decreases the inflammatory process, infection rates and reduces length of hospital stay in surgical patients, however studies are often conducted on heterogeneous groups of patients with varying composition of the immunonutrition. We aim to investigate the effect of immunonutrition on patients undergoing major upper gastrointestinal surgery by assessment of (i) the inflammatory and immune response and (ii) changes in clinical outcome when compared to a randomised control receiving conventional feeding. Method: A prospective double-blind randomised controlled study was undertaken to compare a feed supplemented with glutamine, arginine, ω-3 fatty acids and tributyrin, vitamin C, E and B-carotene and micronutrients (zinc, selenium and chromium) to an isonitrogenous, isocaloric control feed in patients undergoing major upper GI surgery. The primary end-points were defined as C-reactive protein (CRP), prealbumin and retinol binding pr...