Protein-sparing therapy after major abdominal surgery: lack of clinical effects. Protein-Sparing Therapy Study Group.
OBJECTIVE
A prospective multicenter randomized trial was designed to evaluate the clinical efficacy of postoperative protein-sparing therapy.


BACKGROUND
The metabolic effect of postoperative protein-sparing therapy has been shown by several studies, but the clinical utility of this treatment has not been investigated by large prospective trials.


METHODS
Six hundred seventy-eight patients undergoing major elective abdominal surgery were randomly assigned to receive either protein-sparing therapy after surgery (protein-sparing therapy group) or conventional therapy (control group). The patients were monitored for postoperative complications and mortality.


RESULTS
The rate of major postoperative complications was similar in both groups (protein-sparing therapy group, 19.5%; control group, 20.9%; p=0.66) as were the overall postoperative mortality rates (4.7% and 3.5%, respectively; p=0.43).


CONCLUSIONS
The present study indicates that routine protein-sparing therapy for patients normonourished or mildly malnourished undergoing major abdominal surgery is not clinically justified.
Doglietto
G B
GB
Istituto di Clinica Chirurgica, UCSC, Roma, Italy.
Gallitelli
L
L
Pacelli
F
F
Bellantone
R
R
Malerba
M
M
Sgadari
A
A
Crucitti
F
F
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D004044:Dietary Proteins / Q000008:administration & dosage*; D004066:Digestive System Diseases / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods*; D011182:Postoperative Care; D011446:Prospective Studies
D004044:Dietary Proteins