Attenuation of the systemic inflammatory response and infectious complications after gastrectomy with preoperative oral arginine and omega-3 fatty acids supplemented immunonutrition
Okamoto Y, Okano K, Izuishi K, Usuki H, Wakabayashi H, Suzuki Y
World journal of surgery · 113 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
- 2009-07-22 · World J Surg · vol. 33 · número 9 · págs. 1815–1821
- Editorial
- Springer Science+Business Media
- Citado
- 139 citas · más que el 97% de estudios similares · 6.8× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 37 trabajos
- Acceso
- De pago
- Áreas de investigación
- Clinical Nutrition and Gastroenterology · Enhanced Recovery After Surgery · Cancer, Stress, Anesthesia, and Immune Response
- Palabras clave
- gastric cancer, gastrectomy, L-arginine, omega-3 fatty acids, systemic inflammatory response syndrome, postoperative infection, CD4+ T cell immunity, cell-mediated immunity, postoperative complications
- MeSH
- humans, stomach neoplasms, postoperative complications, fatty acids, omega-3, arginine, lymphocyte count, treatment outcome, preoperative care, gastrectomy, administration, oral, incidence, analysis of variance, chi-square distribution, statistics, nonparametric, immunity, cellular, dietary supplements, adult, aged, aged, 80 and over, middle aged, female, male, systemic inflammatory response syndrome, infections
6 autores
- Yoshiki Okamoto🇯🇵 · autor de correspondenciaKagawa University
- Keiichi Okano🇯🇵Kagawa University
- Kunihiko Izuishi🇯🇵Kagawa University
- Hisashi Usuki🇯🇵Kagawa University
- Hisao Wakabayashi🇯🇵Kagawa University
- Yasuyuki Suzuki🇯🇵Kagawa University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Past trials have shown perioperative immunonutrition to improve the outcome for patients with gastric cancer. The present study was designed to evaluate the effect of preoperative oral immunonutrition on cellular immunity, the duration of the systemic inflammatory response syndrome (SIRS), and detailed postoperative complications in patients with gastric cancer.
Methods
Sixty patients with gastric cancer were randomly assigned to two groups: one group received immune-enhanced formulas supplemented with arginine and omega-3 fatty acids (immune-enhancing diet (ID) group, n = 30); the other received standard formulas (conventional diet (CD) group, n = 30) for 7 days before the operation. These groups were well matched in terms of age, sex, operations, cancer stages, and intraoperative variables. The postoperative outcome was evaluated based on clinical variables, including postoperative infectious complications, noninfectious complications, and SIRS duration. In addition, the perioperative state of cellular immunity was evaluated and compared between the two groups.
Results
The incidence of postoperative infectious complications in the ID group (6%) was significantly (p < 0.05) lower than that of the CD group (28%). The duration of SIRS in the ID group (0.77 +/- 0.9 days) was significantly (p < 0.05) shorter than that in the CD group (1.34 +/- 1.45 days). The postoperative lymphocyte and CD4(+)T-cell counts significantly decreased (p < 0.05) in both groups. However, the number of CD4(+)T-cells on preoperative day 1 and postoperative day 7 was significantly (p < 0.05) higher in the ID group than in the CD group.
Conclusions
Preoperative oral immune-enhanced formulas supplemented with arginine and omega-3 fatty acids enhanced the immune status of the patients, reduced the duration of SIRS, and decreased the incidence of postoperative infectious complications. CD4(+)T-cell immunity likely played an important role in the modulation of the postoperative immune and inflammatory response after gastrectomy.
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