Effect of preoperative immunonutrition on body composition in patients undergoing abdominal cancer surgery.
OBJECTIVE
Preoperative immunonutrition may induce changes that modulate stress responses and improve the outcome of patients undergoing abdominal cancer surgery. We evaluated the effectiveness of preoperative immunonutrition using an immune-enhancing diet product called Impact.


METHODS
Forty patients aged 20-75 years, who were scheduled to undergo abdominal cancer surgery, were given Impact for 5 days preoperatively, at 1000 ml/day, in addition to a regular diet. We took various measurements before and after Impact administration.


RESULTS
All but two patients tolerated a daily intake >900 ml (mean: 924 ml). The serum retinol-binding protein level increased from 3.21 to 3.76 mg/dl and the arginine level increased from 91.9 to 112.0 mmol/ml after Impact intake. The urinary excretion of uracil increased significantly, from 57.6 to 88.9 mmol/g creatinine, as did the content of n-3 fatty acids and the n-3/n-6 ratio in membrane phospholipids from the white blood cells. These changes were not observed in the two patients who did not tolerate Impact. There was no significant improvement in clinical outcome.


CONCLUSIONS
Preoperative immunonutrition was well tolerated by cancer patients. It induced structural changes in the white blood cell membranes and increased the body store of arginine and nucleotides. These effects may modulate the response to surgical stress.
Tsujinaka
Toshimasa
T
Department of Surgery, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-Ku, Osaka, 540-0006, Japan.
Hirao
Motohiro
M
Fujitani
Kazumasa
K
Mishima
Hideyuki
H
Ikenaga
Masakazu
M
Sawamura
Toshiro
T
Kurata
Miki
M
D000008:Abdominal Neoplasms / Q000178:diet therapy* / Q000601:surgery*; D000328:Adult; D000368:Aged; D001823:Body Composition / Q000502:physiology*; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods*; D016896:Treatment Outcome
D004044:Dietary Proteins