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Arch Surg. 1999 Apr;134(4):428-33.

Perioperative immunonutrition in patients undergoing cancer surgery: results of a randomized double-blind phase 3 trial.

Author information

1
Department of Surgery, Scientific Institute San Raffaele Hospital, Milan, Italy. braga.marco@hsr.it

Abstract

HYPOTHESIS:

Perioperative administration of a supplemented enteral formula may reduce the rate of postoperative infections.

DESIGN:

Prospective, randomized, double-blind clinical trial.

SETTING:

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 omega3 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.

PMID:
10199318
[Indexed for MEDLINE]

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