Document Detail


Randomized clinical trial of the effects of perioperative use of immune-enhancing enteral formula on metabolic and immunological status in patients undergoing esophagectomy.
MedLine Citation:
PMID:  17653789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although perioperative immune-enhancing enteral formula (IEEF) is effective to decrease the rate of infectious complications, it is not clear whether perioperative use of IEEF decreases the incidence of postoperative complications and improves clinical outcome in patients who have undergone esophagectomy. A prospective randomized clinical trial was performed to examine the effects of perioperative IEEF on nutritional and immunological status in patients with esophageal carcinoma who have been treated with esophagectomy. METHODS: A total of 30 patients were randomly assigned to two groups, each receiving 3 days of preoperative and postoperative enteral nutrition through jejunostomy started within 24 h after operation, either with immune-enhancing enteral formula (group IEEF, n = 16) or with regular polymeric enteral formula (group C, n = 14). Preoperative and postoperative nutritional and immunological parameters and clinical outcome were examined. RESULTS: A significant increase in the serum concentration of ornithine was noted in group IEEF and it peaked at 5 days after surgery. The equivalent values were significantly lower in group C. There was no difference in serum dochosahexaic acid between the two groups. The n-3/n-6 fatty acid ratio in group IEEF was significantly higher than in group C at 7 days after surgery. Peripheral percent lymphocyte fraction and total lymphocyte count in group IEEF were both significantly higher than those in group C. While T cell fraction of peripheral lymphocytes in group IEEF at 3 days after surgery, B cell fraction in group IEEF at 5 and 7 days after surgery was significantly higher than those in group C, suggesting that perioperative IEEF caused a shift towards B cell proliferation. CONCLUSIONS: Perioperative use of IEEF caused a significant increase in the total lymphocyte count at 3 and 5 days after operation and caused a shift toward B cell proliferation, which may possibly be beneficial to decrease the incidence of postoperative infectious complications.
Authors:
Yoichi Sakurai; Toshihiko Masui; Ikuo Yoshida; Shuhei Tonomura; Mitsutaka Shoji; Yasuko Nakamura; Jun Isogaki; Ichiro Uyama; Yoshiyuki Komori; Masahiro Ochiai
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  World journal of surgery     Volume:  31     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-18     Completed Date:  2008-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2150-7; discussion 2158-9     Citation Subset:  IM    
Affiliation:
Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo Kutsukake-cho, Toyoake Aichi 470-1192, Japan. ysakurai@fujita-hu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
8,11,14-Eicosatrienoic Acid / blood
Aged
Arachidonic Acid / blood
C-Reactive Protein / analysis
Enteral Nutrition
Esophageal Neoplasms / immunology,  metabolism,  surgery*
Esophagectomy* / adverse effects
Fatty Acids / blood
Female
Food, Formulated*
Humans
Immunoglobulins / blood
Interleukin-6 / blood
Lymphocyte Count
Male
Middle Aged
Ornithine / blood
Perioperative Care*
Postoperative Complications / epidemiology,  prevention & control
Prospective Studies
Chemical
Reg. No./Substance:
0/Fatty Acids; 0/Immunoglobulins; 0/Interleukin-6; 506-32-1/Arachidonic Acid; 7006-33-9/Ornithine; 7324-41-6/8,11,14-Eicosatrienoic Acid; 9007-41-4/C-Reactive Protein

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


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