Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients
Liang B, Wang S, Ye YJ, Yang XD, Wang YL, Qu J, Xie QW, Yin MJ
World journal of gastroenterology · 104 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Ensayo controlado aleatorizado (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Eventos clínicos como enfermedad o muerte
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2008-01-01 · World J Gastroenterol · vol. 14 · número 15 · pág. 2434
- Editorial
- Baishideng Publishing Group
- Citado
- 134 citas · más que el 95% de estudios similares · 5.1× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 31 trabajos
- Acceso
- Acceso abierto (revista híbrida) · CC-BY-NC
- Áreas de investigación
- Clinical Nutrition and Gastroenterology · Fatty Acid Research and Health · Enhanced Recovery After Surgery
- Palabras clave
- omega-3 fatty acids, fish oil, total parenteral nutrition, colorectal cancer, postoperative nutrition, immunomodulation, interleukin-6, TNF-α, CD4/CD8 ratio, lymphocyte subsets, length of hospital stay, postoperative infection, lipid emulsions, Omegaven, Intralipid
- MeSH
- immune system, humans, colorectal neoplasms, fatty acids, omega-3, soybean oil, fish oils, tumor necrosis factor-alpha, interleukin-6, cd4 lymphocyte count, cd4-cd8 ratio, treatment outcome, parenteral nutrition, length of stay, postoperative care, digestive system surgical procedures, prospective studies, double-blind method, aged, middle aged, female, male, cd3 complex
8 autores
- Bin Liang🇨🇳Peking University People's Hospital
- Shan Wang🇳🇱🇨🇳 · autor de correspondenciaMaastricht University Medical Centre; Peking University People's Hospital
- Yingjiang Ye🇳🇱🇨🇳Maastricht University Medical Centre; Peking University People's Hospital
- Xiaodong Yang🇳🇱🇨🇳Maastricht University Medical Centre; Peking University People's Hospital
- Youli Wang🇳🇱🇨🇳Maastricht University Medical Centre; Peking University People's Hospital
- Jun Qu🇳🇱🇨🇳Maastricht University Medical Centre; Peking University People's Hospital
- Qi-Wei Xie🇳🇱🇨🇳Maastricht University Medical Centre; Peking University People's Hospital
- Mujun Yin🇳🇱🇨🇳Maastricht University Medical Centre; Peking University People's Hospital
Resumen
El texto original del estudio, en el idioma en que se publicó.
Aim
To investigate the effect of omega-3 fatty acid parenteral supplementation postoperatively on clinical outcomes and immunomodulation in colorectal cancer patients.
Methods
Forty-two patients undergoing radical colorectal cancer resection with an indication for total parenteral nutrition postoperatively were enrolled in this prospective, double-blind, randomized, controlled study. Patients received total parenteral nutrition supplemented with either soybean oil (LCT; Intralipid, Fresenius-Kabi, SO group, n = 21) or a combination of omega-3 fish oil and soybean oil (LCT:fish oil = 5:1, fish oil; Omegaven, Fresenius-Kabi, FO group, n = 21), up to a total of 1.2 g lipid/kg per day for 7 d postoperatively. A same volume calorie and nitrogen was administrated. Routine blood test, biochemistry, systemic levels of IL-6 and TNF-alpha, percentage of CD3+, CD4+, and CD8+ lymphocytes were evaluated preoperatively and on postoperative d 1 and 8. Patient outcome was evaluated considering mortality during the hospital stay, length of postoperative hospital stay, and occurrence of infectious complications.
Results
Both lipid regimens were well tolerated. No differences between the two groups were noticed in demographics, baseline blood test, biochemistry, serum levels of IL-6 and TNF-alpha, percentage of CD4+, CD8+ lymphocytes, and ratios of CD4+/CD8+. Compared with those on postoperative d 1, serum IL-6 levels on postoperative d 8 were significantly depressed in the FO group than in the reference group (-44.43 +/- 30.53 vs -8.39 +/- 69.08, P = 0.039). Simultaneously, the ratios of CD4+/CD8+ were significantly increased in the FO group (0.92 +/- 0.62 vs 0.25 +/- 1.22, P = 0.035). In addition, depression of serum TNF-alpha levels (-0.82 +/- 2.71 vs 0.27 +/- 1.67, P = 0.125) and elevation of CD3+ and CD4+ lymphocyte percentage (12.85 +/- 11.61 vs 3.84 +/- 19.62, P = 0.081, 17.80 +/- 10.86 vs 9.66 +/- 17.55, P = 0.084, respectively) were higher in the FO group than in the reference group. Patients in the FO group tended to need a shorter postoperative hospital stay (17.45 +/- 4.80 d vs 19.62 +/- 5.59 d, P = 0.19). No statistically significant difference was found when stratified to mortality and occurrence of infectious complications.
Conclusion
Postoperative supplementation of omega-3 fatty acids may have a favorable effect on the outcomes in colorectal cancer patients undergoing radical resection by lowering the magnitude of inflammatory responses and modulating the immune response.
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