Immunonutrition in elective gastrointestinal surgery patients.
BACKGROUND
Previous trials have shown that perioperative immunonutrition could protect patients from infectious complications after gastrointestinal cancer operations. The purpose of this study was to determine whether perioperative immunonutrition decreases postoperative morbidity, especially infection complications, mortality and length of hospital stay in patients undergoing major gastrointestinal tract surgery.


METHODS
One hundred patients with a planned elective operation for benign or malignant gastrointestinal illness were randomized into two groups: group 1) oral supplementation for five days before and five days after surgery with 900 mL/day of a formula enriched with arginine, gamma-3-fatty acid and RNA + liquid diet ad libitum on one and two postoperative day and then solid food (immunonutrition group; n = 50) or group 2) no artificial nutrition before and after surgery, on one and two postoperative day intravenous solution of 5% glucose and electrolytes and then normal diet (conventional group; n = 50).


RESULTS
The groups were comparable for all key baseline and surgical characteristics. There were nine (18%) infectious complications in both groups. Overall complication rates were 28% (n = 14) in the immunonutrition group and 24% (n = 12) in the conventional group. No significant difference between the groups was found in complication rates, mortality or length of hospital stay.


CONCLUSIONS
Routine perioperative immunonutrition to the patients undergoing major gastrointestinal surgery is not beneficial.
Helminen
H
H
Department of Surgery, Central Hospital, Seinäjoki, Finland. heli.helminen@epshp.fi
Raitanen
M
M
Kellosalo
J
J
D000276:Adjuvants, Immunologic / Q000008:administration & dosage*; D001120:Arginine / Q000008:administration & dosage; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004333:Drug Administration Routes; D017558:Elective Surgical Procedures; D004750:Enteral Nutrition / Q000379:methods*; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000628:therapy*; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods*; D010865:Pilot Projects; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012313:RNA / Q000008:administration & dosage; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D015525:Fatty Acids, Omega-3; D012313:RNA; D001120:Arginine; D005947:Glucose