Randomized clinical trial with an enteral arginine-enhanced formula in early postsurgical head and neck cancer patients.
OBJECTIVE
Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients using an arginine-enhanced formula could improve nutritional variables as well as clinical outcomes.


METHODS
Randomized clinical trial.


METHODS
Tertiary care.


METHODS
A population of 90 patients with oral and laryngeal cancer was enrolled.


METHODS
At surgery, patients were randomly allocated to two groups: (a) patients receiving an arginine-enhanced formula with arginine and fiber (group I) and (b) patients receiving an isocaloric, isonitrogenous formula with fiber enteral formula (group II).


RESULTS
No significant intergroup differences in the trend of the three plasma proteins (albumin, transferrin, prealbumin) and lymphocytes were detected. Gastrointestinal tolerance (diarrhea) was better in group II than I (40% group I and 13% group II: P<0.05). The postoperative complications due to infections were similar in both groups (4% group I and 9% group II: ns). Fistula (wound complication) was less frequent in the enriched nutrition group (5% group I and 11% group II: P<0.05); wound infection was similar in both groups. The length of postoperative stay was better in group I than II (25.8+/-15 days vs 35+/-24.6 days; P<0.05).


CONCLUSIONS
In conclusion, arginine-enhanced formula improves fistula rates in postoperative head and neck cancer patients and decreases length of stay.
de Luis
D A
DA
Institute of Endocrinology and Nutrition, Medicine School and Unit of Investigation, Hospital Rio Hortega, University of Valladolid, Valladolid, Spain. dadluis@yahoo.es
Izaola
O
O
Cuellar
L
L
Terroba
M C
MC
Aller
R
R
D001120:Arginine / Q000627:therapeutic use*; D003967:Diarrhea / Q000453:epidemiology; D004750:Enteral Nutrition; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
D001120:Arginine