Document Detail


Perioperative intravenous glutamine supplemetation in major abdominal surgery for cancer: a randomized multicenter trial.
MedLine Citation:
PMID:  19801932     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To investigate whether perioperative intravenous glutamine supplementation may affect surgical morbidity. SUMMARY BACKGROUND DATA: Small-sized randomized trials showed a trend toward a reduction of postoperative infections in surgical patients receiving glutamine. METHODS:: A randomized, multicentre trial was carried out in 428 subjects who were candidates for elective major gastrointestinal surgery. Inclusion criteria were: documented gastrointestinal cancer, weight loss <10% in previous 6 months, and age >18 years. Patients received either intravenous infusion of L-alanine-L-glutamine dipeptide (0.40 g/kg/d; equal to 0.25 g of free glutamine) (Ala-Glu group, n = 212), or no supplementation (control group, n = 216). Glutamine infusion began the day before operation and continued postoperatively for at least 5 days. No postoperative artificial nutrition was allowed unless patients could not adequately eat by day 7. Postoperative morbidity was assessed by independent observers according to a priori definition. RESULTS: Patients were homogenous for baseline and surgical characteristics. Mean percent of weight loss was 1.4 (2.7) in controls and 1.4 (2.4) in Ala-Glu group. Overall postoperative complication rate was 34.9% (74/212) in Ala-Glu and 32.9% (71/216) in control group (P = 0.65). Infectious morbidity was 19.3% (41/212) in Ala-Glu group and 17.1% (37/216) in controls (P = 0.55). The rate of major complications was 7.5% (16/212) in Ala-Glu group and 7.9% (17/216) in controls (P = 0.90). Mean length of hospitalization was 10.2 days (4.8) in Ala-Glu group versus 9.9 days (3.9) in controls (P = 0.90). The rate of patients requiring postoperative artificial nutrition was 13.2% (28/212) in Ala-Glu group and 12.0% (26/216) in controls (P = 0.71). CONCLUSIONS: Perioperative glutamine does not affect outcome in well-nourished GI cancer patients.
Authors:
Luca Gianotti; Marco Braga; Roberto Biffi; Federico Bozzetti; Luigi Mariani;
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Annals of surgery     Volume:  250     ISSN:  1528-1140     ISO Abbreviation:  Ann. Surg.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-11     Completed Date:  2009-12-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372354     Medline TA:  Ann Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  684-90     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Milano-Bicocca University, S. Gerardo Hospital, Monza, Italy. luca.gianotti@unimib.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Dipeptides / administration & dosage
Female
Gastrointestinal Neoplasms / surgery*
Glutamine / administration & dosage*,  pharmacokinetics
Humans
Infusions, Intravenous
Male
Middle Aged
Perioperative Care*
Postoperative Complications / prevention & control*
Chemical
Reg. No./Substance:
0/Dipeptides; 13187-90-1/alanylglutamate; 56-85-9/Glutamine
Investigator
Investigator/Affiliation:
Giorgio Capuano / ; Rosalba Lembo / ; Annarita Sabbatini / ; Luca Cozzaglio / ; Massimiliano Coladonato / ; Simona Rocchetti / ; Aldo Beneduce / ; Nicolò Tamini / ; Sara Coppola / ; Riccardo Pirovano / ; Lucia Cipolat / ; Paolo Geretto / ; Felice Borghi / ; Leonardo Di Cosmo / ; Giuseppe Vuolo / ; Maria Luisa Amerio / ; Stefania Bianchi / ; Barbara Pogliano / ; Bartolomeo Marino / ; Gian Michele Amerio / ; Maria Luisa Terranova / ; Grazia Leonello / ; Giovanna Rivoli / ; Eriberto Farinella /

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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