TY - JOUR
T1 - Perioperative immunonutrition in patients undergoing cancer surgery
T2 - Results of a randomized double-blind phase 3 trial
AU - Braga, Marco
AU - Gianotti, Luca
AU - Radaelli, Giovanni
AU - Vignali, Andrea
AU - Mari, Gilberto
AU - Gentilini, Oreste
AU - Di Carlo, Valerio
PY - 1999/4
Y1 - 1999/4
N2 - Hypothesis: Perioperative administration of a supplemented enteral formula may reduce the rate of postoperative infections. Design: Prospective, randomized, double-blind clinical trial. Selling: Department of surgery at a university hospital. Patients: Two hundred six patients with neoplasm of colorectum, stomach, or pancreas. Intervention: Patients were randomized to drink 1 L/d of either a control enteral formula (n = 104) or the same formula enriched with arginine, RNA, and ω3 fatty acids (n = 102) for 7 consecutive days before surgery. The 2 diets were isoenergetic and isonitrogenous. Jejunal infusion with the same formulas was started 6 hours after operation and continued until postoperative day 7. Main Outcome Measures: Rate of postoperative infectious complications and length of hospital stay. Results: Both groups were comparable for age, sex, weight loss, Karnofsky scale score, nutritional status, hemoglobin level, duration of surgery, blood loss, and rate of homologous transfusion. Intent-to-treat analysis showed a 14% (14/102) infectious complication rate in the supplemented group vs 30% (31/104) in the control group (P = .009). In the eligible population, the postoperative infection rate was 11% (9/85) in the supplemented group vs 24% (21/86) in the control group (P = .02). The mean ± SD length of postoperative stay was 11.1 ± 4.4 days in the supplemented group and 12.9 ± 4.6 in the control group (P = .01). Conclusion: Perioperative administration of a supplemented enteral formula significantly reduced postoperative infections and length of stay in patients undergoing surgery for cancer.
AB - Hypothesis: Perioperative administration of a supplemented enteral formula may reduce the rate of postoperative infections. Design: Prospective, randomized, double-blind clinical trial. Selling: Department of surgery at a university hospital. Patients: Two hundred six patients with neoplasm of colorectum, stomach, or pancreas. Intervention: Patients were randomized to drink 1 L/d of either a control enteral formula (n = 104) or the same formula enriched with arginine, RNA, and ω3 fatty acids (n = 102) for 7 consecutive days before surgery. The 2 diets were isoenergetic and isonitrogenous. Jejunal infusion with the same formulas was started 6 hours after operation and continued until postoperative day 7. Main Outcome Measures: Rate of postoperative infectious complications and length of hospital stay. Results: Both groups were comparable for age, sex, weight loss, Karnofsky scale score, nutritional status, hemoglobin level, duration of surgery, blood loss, and rate of homologous transfusion. Intent-to-treat analysis showed a 14% (14/102) infectious complication rate in the supplemented group vs 30% (31/104) in the control group (P = .009). In the eligible population, the postoperative infection rate was 11% (9/85) in the supplemented group vs 24% (21/86) in the control group (P = .02). The mean ± SD length of postoperative stay was 11.1 ± 4.4 days in the supplemented group and 12.9 ± 4.6 in the control group (P = .01). Conclusion: Perioperative administration of a supplemented enteral formula significantly reduced postoperative infections and length of stay in patients undergoing surgery for cancer.
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U2 - 10.1001/archsurg.134.4.428
DO - 10.1001/archsurg.134.4.428
M3 - Article
C2 - 10199318
AN - SCOPUS:0032976621
VL - 134
SP - 428
EP - 433
JO - Archives of Surgery
JF - Archives of Surgery
SN - 0004-0010
IS - 4
ER -