Comparison of Perioperative Standard and Immunomodulating Enteral Nutrition in Patients Received Major Abdominal Cancer
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ORIGINAL ARTICLE
Comparison of Perioperative Standard and Immunomodulating Enteral Nutrition in Patients Received Major Abdominal Cancer Surgery: a Prospective, Randomized, Controlled Clinical Trial Serkan Fatih Yeğen 1 & Mehmet Tolga Kafadar 2 & Mehmet Ali Gök 3 Received: 31 July 2019 / Accepted: 26 February 2020 # Association of Surgeons of India 2020
Abstract The aim of this study was to compare the effects of standard and immunomodulating enteral nutrition on the clinical outcomes of the patients undergoing major abdominal cancer surgery. Patients who underwent a major elective abdominal cancer surgery in our clinic were randomly assigned preoperatively to two groups according to enteral nutritional intervention; Standard (ST) or Immunomodulating (IM) group. The patients who were randomized to ST and IM groups received Resource® 2.0 fiber and OraI Impact® RTD 7 days prior to surgery and 30 days after surgery, respectively. The outcome variables were as follows; infections (surgical site infection, pneumonia, abdominal abscess or septicemia), non-infectious complications (wound dehiscence, anastomotic leak, adult respiratory distress syndrome (ARDS), multi-organ failure), need for intensive care unit admission, need for re-operation, length of hospital stay, and hospital mortality. A total of 78 patients were randomized (n = 39 in each group). Fortyfive (58%) of patients were male and mean age was 62.9 ± 13.4 (25–85). The mean pre-operative Body Mass Index (BMI) and Nutritional Risk Screening (NRS-2002) scores were 26.5 ± 5.4 and 2.3 ± 1.1, respectively. There were no significant differences in gender, age, BMI, and NRS-2002 scores between groups (p ≥ 0.05). ASA scores, surgical interventions also were similar in two groups. Rate of surgical site infection in groups ST and IM was 72% (n = 28) and 15% (n = 6), (p < 0.001). Rate of pneumonia in groups ST and IM was 25% (n = 10) and 0% (n = 0), (p < 0.001). Rate of urinary tract infection in groups ST and IM was 33.3% (n = 13) and 5.1% (n = 2), (p < 0.03). Length of hospital stay in groups ST and IM was 8.4 ± 4.8 and 6.1 ± 1.4, respectively (p < 0,003). There were no significant differences in other outcome variables between groups (p ≥ 0.05, for all comparisons). Perioperative immunomodulating enteral nutrition may reduce the incidence of surgical site infection, pneumonia, urinary tract infection and length of hospital stays in patients who received abdominal cancer surgery. Keywords Immunonutrition . Perioperative . Abdominal cancer surgery
Introduction Surgery is the primary choice of treatment modality for gastrointestinal cancers. The objectives of the surgical treatment
* Mehmet Tolga Kafadar [email protected] 1
Ali Osman Sönmez Oncology Hospital Clinic of General Surgery, Bursa, Turkey
2
Health Sciences University Mehmet Akif Inan Training and Research Hospital Clinic of General Surgery, Şanlıurfa, Turkey
3
Health Sciences University Derince Training and Research Hospital Clinic of General Surgery, Kocaeli, Turkey
are to avoid postoperati
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