Randomized clinical trial of omega-3 fatty acid-supplemented enteral nutrition versus standard enteral nutrition in patients undergoing oesophagogastric cancer surgery
Sultan J, Griffin SM, Di Franco F, Kirby JA, Shenton BK, Seal CJ, Davis P, Viswanath YK, Preston SR, Hayes N
The British journal of surgery · 100 citas
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 independiente
Según la declaración de financiación del texto completo.
Publicación
- Publicado
- 2012-01-11 · Br J Surg · vol. 99 · número 3 · págs. 346–355
- Editorial
- Oxford University Press
- Citado
- 134 citas · más que el 99% de estudios similares · 10.0× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 30 trabajos
- Acceso
- Lectura gratuita
- Áreas de investigación
- Clinical Nutrition and Gastroenterology · Fatty Acid Research and Health · Enhanced Recovery After Surgery
- Palabras clave
- omega-3 fatty acids, immunonutrition, enteral nutrition, esophagectomy, gastrectomy, perioperative nutrition, HLA-DR expression, monocytes, T cells, n-6/n-3 ratio, postoperative morbidity, immunosuppression
- MeSH
- t-lymphocytes, monocytes, humans, esophageal neoplasms, stomach neoplasms, postoperative complications, fatty acids, omega-3, fatty acids, fatty acids, omega-6, c-reactive protein, hla-dr antigens, enteral nutrition, postoperative care, preoperative care, esophagectomy, gastrectomy, analysis of variance, prospective studies, dietary supplements, adult, aged, middle aged, female, male
10 autores
- Javed Sultan🇬🇧Royal Victoria Infirmary
- S M Griffin🇬🇧Royal Victoria Infirmary
- F Di Franco🇬🇧Royal Victoria Infirmary
- John Andrew Kirby🇬🇧Newcastle University
- Brian Keith Shenton🇬🇧Newcastle University
- Chris J. Seal🇬🇧Newcastle University
- Philip J. Davis🇬🇧James Cook University Hospital
- Y K S Viswanath🇬🇧James Cook University Hospital
- Shaun R. Preston🇬🇧Royal Victoria Infirmary
- Nick Hayes🇬🇧Royal Victoria Infirmary
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
Oesophagogastric cancer surgery is immunosuppressive. This may be modulated by omega-3 fatty acids (O-3FAs). The aim of this study was to assess the effect of perioperative O-3FAs on clinical outcome and immune function after oesophagogastric cancer surgery.
Methods
Patients undergoing subtotal oesophagectomy and total gastrectomy were recruited and allocated randomly to an O-3FA enteral immunoenhancing diet (IED) or standard enteral nutrition (SEN) for 7 days before and after surgery, or to postoperative supplementation alone (control group). Clinical outcome, fatty acid concentrations, and HLA-DR expression on monocytes and activated T lymphocytes were determined before and after operation.
Results
Of 221 patients recruited, 26 were excluded. Groups (IED, 66; SEN, 63; control, 66) were matched for age, malnutrition and co-morbidity. There were no differences in morbidity (P = 0·646), mortality (P = 1·000) or hospital stay (P = 0·701) between the groups. O-3FA concentrations were higher in the IED group after supplementation (P < 0·001). The ratio of omega-6 fatty acid to O-3FA was 1·9:1, 4·1:1 and 4·8:1 on the day before surgery in the IED, SEN and control groups (P < 0·001). There were no differences between the groups in HLA-DR expression in either monocytes (P = 0·538) or activated T lymphocytes (P = 0·204).
Conclusion
Despite a significant increase in plasma concentrations of O-3FA, immunonutrition with O-3FA did not affect overall HLA-DR expression on leucocytes or clinical outcome following oesophagogastric cancer surgery.
Registration number
ISRCTN43730758 (http://www.controlled-trials.com).
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