title: Early postoperative glutamine-supplemented parenteral nutrition versus enteral immunonutrition in cancer patients undergoing major gastrointestinal surgery.
abstract: OBJECTIVE
  The aim of this study was to determine whether the type of postoperative feeding, glutamine-supplemented parenteral nutrition or enteral immunonutrition, can modify morbidity and outcome in malnourished cancer patients undergoing major surgery in the gastrointestinal tract.
  
  
  METHODS
  Twenty-nine consecutive malnourished patients undergoing major elective surgery for carcinoma of the stomach (n=8), pancreas (n=8), liver (n=1), and colon (n=12), were randomly assigned to receive from the first postoperative day either enteral immunonutrition or glutamine-supplemented parenteral nutrition, for at least 5 consecutive days. Postoperative major and minor morbidity and mortality were recorded. Data analysis was done using the Fisher's exact test.
  
  
  RESULTS
  Fifteen patients received glutamine-supplemented parenteral nutrition and 14 received enteral immunonutrition. The overall incidence of postoperative complications was 33.3% in the parenteral nutrition group versus 50% in the enteral nutrition group (p=0.2). Subdividing postoperative complications into different types, the rates of major complications were similar in both groups of patients (13.3 and 21.4% respectively, p=0.4). Similarly, there were no significant differences between the two groups considering minor postoperative noninfectious complications, infectious complications, and mortality.
  
  
  CONCLUSIONS
  In malnourished cancer patients undergoing major gastrointestinal surgery, morbidity and mortality are not significantly influenced by the type of postoperative feeding.
authors.affiliation: Department of Surgery, Nutrition and Intestinal Failure Unit, "Agios Andreas" General Hospital, Patras, Greece.
authors.forename: V
authors.initials: V
authors.lastname: Alivizatos
authors.forename: P
authors.initials: P
authors.lastname: Athanasopoulos
authors.forename: N
authors.initials: N
authors.lastname: Makris
authors.forename: N
authors.initials: N
authors.lastname: Karageorgos