Preoperative oral supplement with immunonutrients in cancer patients.
BACKGROUND
Early postoperative enteral nutrition with immune-enhancing supplements has helped to restore immune function and reduce infectious complications in patients with cancer undergoing major gastrointestinal operations. The aim of this study was to evaluate the effectiveness of similar supplements (containing arginine and arginine plus omega-3 fatty acids) given preoperatively for 1 week before cancer surgery.


METHODS
In this randomized, double-blinded study, patients scheduled to undergo elective resection of upper gastrointestinal tumors were given one of three different oral liquid supplemental diets (control, arginine, arginine plus omega-3 fatty acids) to be taken each day for 7 days before surgery. Blood samples were obtained upon enrollment, on the morning of surgery, and on postoperative day 1 for analysis of immunologic function.


RESULTS
Mean serum ornithine (a metabolite of arginine) levels were significantly higher compared with controls, but no significant increase in mean serum arginine levels was noted on the morning of surgery for those patients who received arginine as part of the supplement. In conjunction with these findings, there were no differences among groups in mean lymphocyte mitogenesis, mean peripheral blood mononuclear cell production of cytokines, or clinical outcomes.


CONCLUSIONS
Use of oral liquid supplements in this fashion did not improve lymphocyte proliferation or monocyte functions in patients with cancer undergoing major surgery.
McCarter
M D
MD
Department of Surgery, New York Hospital-Cornell University Medical College, NY 100021, USA.
Gentilini
O D
OD
Gomez
M E
ME
Daly
J M
JM
D000368:Aged; D001120:Arginine / Q000008:administration & dosage*; D016207:Cytokines / Q000096:biosynthesis; D019587:Dietary Supplements; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D017053:Infection Control; D008213:Lymphocyte Activation; D008297:Male; D008875:Middle Aged; D008934:Mitogens / Q000494:pharmacology; D009369:Neoplasms / Q000276:immunology* / Q000601:surgery*; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care
D016207:Cytokines; D015525:Fatty Acids, Omega-3; D008934:Mitogens; D001120:Arginine