Enteral nutrition enriched with eicosapentaenoic acid (EPA) preserves lean body mass following esophageal cancer surgery: results of a double-blinded randomized controlled trial
Ryan AM, Reynolds JV, Healy L, Byrne M, Moore J, Brannelly N, McHugh A, McCormack D, Flood P
Annals of surgery · 212 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
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2009-03-01 · Ann Surg · vol. 249 · número 3 · págs. 355–363
- Editorial
- Lippincott Williams & Wilkins
- Citado
- 310 citas · más que el 99% de estudios similares · 16.4× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 43 trabajos
- Acceso
- De pago
- Áreas de investigación
- Clinical Nutrition and Gastroenterology · Nutrition and Health in Aging · Fatty Acid Research and Health
- Palabras clave
- eicosapentaenoic acid, enteral nutrition, esophagectomy, esophageal cancer surgery, lean body mass preservation, fat-free mass loss, perioperative nutrition, postoperative complications, acute phase response, serum cytokines, TNF-α, IL-10, interleukin-8, omega-3 fatty acids, jejunostomy, bioelectrical impedance analysis, immune response
- MeSH
- humans, esophageal neoplasms, weight loss, eicosapentaenoic acid, body mass index, enteral nutrition, esophagectomy, double-blind method, body composition, nutritional status, electric impedance, dietary supplements, aged, middle aged, female, male
9 autores
- Aoife M. Ryan🇮🇪 · autor de correspondenciaTrinity College Dublin; St. James's Hospital
- John Vincent Reynolds🇮🇪 · autor de correspondenciaTrinity College Dublin; St. James's Hospital
- Laura Healy🇮🇪 · autor de correspondenciaTrinity College Dublin; St. James's Hospital
- Miriam Byrne🇮🇪 · autor de correspondenciaTrinity College Dublin; St. James's Hospital
- Jennifer Moore🇮🇪 · autor de correspondenciaTrinity College Dublin; St. James's Hospital
- Niamh Brannelly
- Aisling McHugh
- Deirdre McCormack
- P. Flood
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Esophagectomy represents an exemplar of controlled major trauma, with marked metabolic, immunologic, and physiologic changes as well as an associated high incidence of complications. Eicosapentaenoic acid (EPA) enriched enteral nutrition (EN) modulates immune function and limits catabolism in patients with advanced cancer, but its impact in the peri-operative period is unclear.
Objectives
To examine the effects of perioperative EPA enriched EN on the metabolic, nutritional, and immuno-inflammatory response to esophagectomy, and on postoperative complications.
Methods
In a double-blind design, patients were randomized to a standard EN formula or a formula enriched with 2.2 g EPA/d for 5 days preoperatively (orally) and 21 days postoperatively (jejunostomy). Segmental bioelectrical impedance analysis was performed preoperatively and on POD 21. Postoperative complications were monitored, as well as the acute phase response, coagulation markers, and serum cytokines.
Results
Fifty-three patients (28 EPA, 25 standard) completed the study, and both groups were well matched. Serum and peripheral blood mononuclear cell (PBMC) membrane EPA levels were significantly increased in the EPA group. There was no difference in the incidence of major complications. The EPA group maintained all aspects of body composition postoperatively, whereas patients in the standard EN group lost significant amounts of fat-free mass (1.9 kg, P = 0.030) compared with the EPA group [leg (0.3 kg, P = 0.05), arm (0.17 kg, P = 0.01), and trunk (1.44 kg, P = 0.03)]. The EPA group had a significantly (P < 0.05) attenuated stress response for TNFalpha, IL-10, and IL-8 compared with the standard group.
Conclusions
EPA supplemented early EN is associated with preservation of lean body mass post esophagectomy compared with a standard EN. These properties may merit longer-term study to address its impact on recovery of function and quality of life in models of complex surgery or multimodal cancer treatment regimens.
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