title: The clinical value of parenteral immunonutrition in surgical patients.
abstract: OBJECTIVE
  To analyze the clinical impact and cost-effectiveness of parenteral immunonutrition (PN).
  
  
  METHODS
  Prospective clinical trial of a group of 105 patients operated on for gastric carcinoma between 2001-2003. During the postoperative period, patients were randomly allocated to one of three groups: standard PN (A), PN + glutamine (B) and PN + omega-3-FA (C). The rate and type of complications, hepatic and renal function, cost and treatment tolerance in all groups were analyzed.
  
  
  RESULTS
  Postoperative complications were observed in 11 patients (36.6%) in group A, in 7 (23.3%) in B and in 8 (26.6%) in C. The most common complication was pneumonia. Prealbumin concentration and TLC increased faster in groups B and C. The length of hospital stay was significantly shorter in the immunonutrition groups. The cost of PN was highest in C group, while cost of hospital stay was longer in A.
  
  
  CONCLUSIONS
  Immunostimulating parenteral nutrition helps to reduce the number of infectious complications, improves the function of the immune system, and has no influence on surgical complications, hepatic and renal function and protein synthesis. The cost of immunostimulating treatment based on omega-3-unsaturated fatty acids is higher than standard.
authors.affiliation: 1st Department of General and GI Surgery, Collegium Medicum Jagiellonian University, Cracow, Poland. sklek@mp.pl
authors.forename: S
authors.initials: S
authors.lastname: Kłek
authors.forename: J
authors.initials: J
authors.lastname: Kulig
authors.forename: A M
authors.initials: AM
authors.lastname: Szczepanik
authors.forename: J
authors.initials: J
authors.lastname: Jedrys
authors.forename: P
authors.initials: P
authors.lastname: Kołodziejczyk
mesh_terms: D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D005973:Glutamine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000628:therapy*; D009751:Nutritional Requirements; D010288:Parenteral Nutrition / Q000379:methods*; D011184:Postoperative Period; D011446:Prospective Studies; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3; D005973:Glutamine