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Postoperative enteral immunonutrition in head and neck cancer patients.

Abstract

AIMS

to determine if postoperative feeding of head and neck cancer patients, using an enteral diet supplemented with arginine, improves immunological and nutritional status, and clinical outcome, i.e., reduces postoperative infectious/wound complications and length of stay, when compared with an isocaloric, isonitrogenous control diet.

METHODS

at operation 44 patients were randomized into two groups to receive: a) an enriched diet (n=23);b) an isocaloric, isonitrogenous control diet (n=21). Thirteen patients with a history of significant weight loss (> or = 10% over the last 6 months) were considered malnourished. Preoperatively and on postoperative days 1, 4 and 8 the following parameters were evaluated: albumin, prealbumin, transferrin, total number of lymphocytes, lymphocyte subsets (CD3, CD4, CD8 and CD4/CD8 ratio) and immunoglobulins. Postoperative complications and length of stay were recorded.

RESULTS

'visceral' serum proteins and immunological parameters decreased on postoperative day 1 in both groups. However, only the enriched group demonstrated a significant increase (P<0.05) in the total number of lymphocytes, CD4, CD4/CD8 on postoperative day 4, and total number of lymphocytes, CD3, CD4, CD4/CD8 on postoperative day 8. In the malnourished subgroup the administration of the enriched formula significantly reduced both postoperative infectious/wound complications and length of stay compared with the control group (P<0.05).

CONCLUSIONS

enteral immunonutrition of head and neck cancer patients improves postoperative immunological response. Significant clinical advantages were observed in malnourished patients.

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  • Authors+Show Affiliations

    ,

    Clinical Nutrition Service, Maggiore della Carita Hospital, Novara, Italy.

    , , , ,

    Source

    MeSH

    Arginine
    Enteral Nutrition
    Female
    Head and Neck Neoplasms
    Humans
    Length of Stay
    Lymphocyte Count
    Lymphocytes
    Male
    Middle Aged
    Nutrition Disorders
    Nutritional Status
    Postoperative Care
    Postoperative Complications
    Postoperative Period
    Time Factors
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Journal Article
    Randomized Controlled Trial

    Language

    eng

    PubMed ID

    11104591

    Citation

    Riso, S, et al. "Postoperative Enteral Immunonutrition in Head and Neck Cancer Patients." Clinical Nutrition (Edinburgh, Scotland), vol. 19, no. 6, 2000, pp. 407-12.
    Riso S, Aluffi P, Brugnani M, et al. Postoperative enteral immunonutrition in head and neck cancer patients. Clin Nutr. 2000;19(6):407-12.
    Riso, S., Aluffi, P., Brugnani, M., Farinetti, F., Pia, F., & D'Andrea, F. (2000). Postoperative enteral immunonutrition in head and neck cancer patients. Clinical Nutrition (Edinburgh, Scotland), 19(6), pp. 407-12.
    Riso S, et al. Postoperative Enteral Immunonutrition in Head and Neck Cancer Patients. Clin Nutr. 2000;19(6):407-12. PubMed PMID: 11104591.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Postoperative enteral immunonutrition in head and neck cancer patients. AU - Riso,S, AU - Aluffi,P, AU - Brugnani,M, AU - Farinetti,F, AU - Pia,F, AU - D'Andrea,F, PY - 2000/1/11/pubmed PY - 2001/9/28/medline PY - 2000/1/11/entrez SP - 407 EP - 12 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 19 IS - 6 N2 - AIMS: to determine if postoperative feeding of head and neck cancer patients, using an enteral diet supplemented with arginine, improves immunological and nutritional status, and clinical outcome, i.e., reduces postoperative infectious/wound complications and length of stay, when compared with an isocaloric, isonitrogenous control diet. METHODS: at operation 44 patients were randomized into two groups to receive: a) an enriched diet (n=23);b) an isocaloric, isonitrogenous control diet (n=21). Thirteen patients with a history of significant weight loss (> or = 10% over the last 6 months) were considered malnourished. Preoperatively and on postoperative days 1, 4 and 8 the following parameters were evaluated: albumin, prealbumin, transferrin, total number of lymphocytes, lymphocyte subsets (CD3, CD4, CD8 and CD4/CD8 ratio) and immunoglobulins. Postoperative complications and length of stay were recorded. RESULTS: 'visceral' serum proteins and immunological parameters decreased on postoperative day 1 in both groups. However, only the enriched group demonstrated a significant increase (P<0.05) in the total number of lymphocytes, CD4, CD4/CD8 on postoperative day 4, and total number of lymphocytes, CD3, CD4, CD4/CD8 on postoperative day 8. In the malnourished subgroup the administration of the enriched formula significantly reduced both postoperative infectious/wound complications and length of stay compared with the control group (P<0.05). CONCLUSIONS: enteral immunonutrition of head and neck cancer patients improves postoperative immunological response. Significant clinical advantages were observed in malnourished patients. SN - 0261-5614 UR - https://www.unboundmedicine.com/medline/citation/11104591/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(00)90135-3 DB - PRIME DP - Unbound Medicine ER -