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 ORIGINAL ARTICLE
Year : 2018  |  Volume : 64  |  Issue : 3  |  Page : 155-163

Combination of arginine, glutamine, and omega-3 fatty acid supplements for perioperative enteral nutrition in surgical patients with gastric adenocarcinoma or gastrointestinal stromal tumor (GIST): A prospective, randomized, double-blind study


1 Division of Digestive and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital; Graduate Institute of Clinical Medicine, College of Medicine; Division of Colorectal Surgery, Department of Surgery, Kaohsiung, Taiwan
2 Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital; Division of General Medicine Surgery, Department of Surgery; Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung, Taiwan
3 Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital; Division of General Medicine Surgery, Department of Surgery, Kaohsiung, Taiwan
4 Nutrition Service Team, Kaohsiung Medical University Hospital; Department of Nursing, Kaohsiung, Taiwan
5 Graduate Institute of Clinical Medicine, College of Medicine; Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital; Department of Surgery, Faculty of Medicine, College of Medicine; Nutrition Service Team; Center for Biomarkers and Biotech Drugs; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Correspondence Address:
Dr. J Wang
Graduate Institute of Clinical Medicine, College of Medicine; Division of Colorectal Surgery, Department of Surgery, Kaohsiung Medical University Hospital; Department of Surgery, Faculty of Medicine, College of Medicine; Nutrition Service Team; Center for Biomarkers and Biotech Drugs; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung
Taiwan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jpgm.JPGM_693_17

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Background: Perioperative enteral nutrition (EN) enriched with immune-modulating substrates is preferable for patients undergoing major abdominal cancer surgery. In this study, perioperative EN enriched with immune-modulating nutrients such as arginine, glutamine, and omega-3 fatty acids was evaluated for its anti-inflammatory efficacy in patients with gastric adenocarcinoma or gastrointestinal stromal tumor (GIST) receiving curative surgery. Materials and Methods: This prospective, randomized, double-blind study recruited 34 patients with gastric adenocarcinoma or gastric GIST undergoing elective curative surgery. These patients were randomly assigned to the study group, receiving immune-modulating nutrient-enriched EN, or the control group, receiving standard EN from 3 days before surgery (preoperative day 3) to up to postoperative day 14 or discharge. Laboratory and inflammatory parameters were assessed on preoperative day 3 and postoperative day 14 or at discharge. Adverse events (AEs) and clinical outcomes were documented daily and compared between groups. Results: No significant differences were observed between the two groups in selected laboratory and inflammatory parameters, or in their net change, before and after treatment. AEs and clinical outcomes, including infectious complications, overall complications, time to first bowel action, and length of hospital stay after surgery, were comparable between treatment groups (all P > 0.05). Conclusion: Immune-modulating nutrient-enriched EN had no prominent immunomodulation effect compared with that of standard EN.






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