Efficacy of perioperative immunonutrition in esophageal cancer patients undergoing esophagectomy

被引：58

作者：

Kanekiyo, Shinsuke ^{[1
]}

Takeda, Shigeru ^{[1
]}

Iida, Michihisa ^{[1
]}

Nishiyama, Mitsuo ^{[1
]}

Kitahara, Masahiro ^{[1
]}

Shindo, Yoshitaro ^{[1
]}

Tokumitsu, Yukio ^{[1
]}

Tomochika, Shinobu ^{[1
]}

Tsunedomi, Ryoichi ^{[1
]}

Suzuki, Nobuaki ^{[1
]}

Abe, Toshihiro ^{[2
]}

Yoshino, Shigefumi ^{[3
]}

Hazama, Shoichi ^{[4
]}

Ueno, Tomio ^{[5
]}

Nagano, Hiroaki ^{[1
]}

机构：

[1] Yamaguchi Univ, Dept Gastroenterol Breast & Endocrine Surg, Grad Sch Med, Ube, Yamaguchi, Japan

[2] Kanmon Med Ctr, Shimonoseki, Yamaguchi, Japan

[3] Yamaguchi Univ, Oncol Ctr, Ube, Yamaguchi, Japan

[4] Yamaguchi Univ, Dept Translat Res & Dev Therapeut Canc, Fac Med, Ube, Yamaguchi, Japan

[5] Kawasaki Med Sch, Dept Digest Surg, Kurashiki, Okayama, Japan

来源：

NUTRITION | 2019年 / 59卷

关键词：

Immunonutrition; Esophageal cancer; Esophagectomy; Infective complication; Postoperative nutritional status; RANDOMIZED CLINICAL-TRIAL; SURGERY; NUTRITION; ARGININE; IMMUNE; COMPLICATIONS; MALNUTRITION; INFECTIONS; OUTCOMES; ALBUMIN;

D O I：

10.1016/j.nut.2018.08.006

中图分类号：

R15 [营养卫生、食品卫生]; TS201 [基础科学];

学科分类号：

100403 ;

摘要：

Objective: Malnutrition is common in patients with esophageal cancer, resulting in increased postoperative complications and mortality. Although preoperative immunonutrition can significantly reduce the incidence of postoperative infectious complications, its effect in patietns with esophageal cancer undergoing esophagectomy remains unclear. The aim of this study was to investigate the effects of perioperative immunonutritional support on the postoperative course and long-term survival of this group of patients. Methods: This prospective, randomized study enrolled 40 patients with thoracic esophageal carcinoma undergoing esophagectomy. The patients were divided into two groups and received either immunomodulating enteral nutrition (IMPACT group; IG) or standard enteral nutrition (Ensure group; EG) continuously for 7 d before and 7 d after surgery. Nutritional status, such as rapid turnover protein, postoperative intensive care unit (ICU) length of stay (LOS), postoperative hospital LOS, morbidity, and mortality were investigated prospectively. Results: There were no significant differences in patient demographic characteristics between the two groups. Levels of retinol-binding protein, as a rapid-turnover protein, were significantly higher on postoperative day (POD) -1, 7, and 14 in the IG compared with the EG group (P= 0.009, P= 0.004, and P= 0.024, respectively). The incidence of postoperative infectious complications and changes to therapeutic antibiotics were significantly lower in the IG group than in the EG group (P = 0.048 and P = 0.012, respectively). There was no significant difference in postoperative ICU or postoperative hospital LOS between the two groups. The 5-y progression-free survival rates in the IG and EG groups were 75% and 64%, respectively (P= 0.188), and the overall survival rates were 68% and 55%, respectively (P= 0.187). Conclusions: Perioperative immunonutrition may improve early postoperative nutritional status and reduce postoperative infectious complications in patients with esophageal cancer undergoing esophagectomy. (C) 2018 Elsevier Inc. All rights reserved.

引用

页码：96 / 102

页数：7

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