Effect of preoperative immunonutrition and other nutrition models on cellular immune parameters.
OBJECTIVE
To evaluate the effects of preoperative immunonutrition and other nutrition models on the cellular immunity parameters of patients with gastrointestinal tumors before surgical intervention. In addition, effects on postoperative complications were examined.


METHODS
Patients with gastrointestinal tumors were randomized into 3 groups. The immunonutrition group received a combination of arginine, fatty acids and nucleotides. The second and third group received normal nutrition and standard enteral nutrition, respectively. Nutrition protocols were administered for 7 d prior to the operation. Nutritional parameters, in particular prealbumin levels and lymphocyte subpopulations (CD4+, CD8+, CD16+/56+, and CD69 cells) were evaluated before and after the nutrition protocols. Groups were compared in terms of postoperative complications and duration of hospital stay.


RESULTS
Of the 42 patients who completed the study, 16 received immunonutrition, 13 received normal nutrition and 13 received standard enteral nutrition. prealbumin values were low in every group, but this parameter was improved after the nutritional protocol only in the immunonutrition group (13.64+/-8.83 vs 15.98+/-8.66, P=0.037). Groups were similar in terms of CD4+, CD16+/56, and CD69+ prior to the nutritional protocol; whereas CD8+ was higher in the standard nutrition group compared to the immunonutrition group. After nutritional protocols, none of the groups had an increase in their lymphocyte subpopulations. Also, groups did not differ in terms of postoperative complications and postoperative durations of hospital stay.


CONCLUSIONS
Preoperative immunonutrition provided a significant increase in prealbumin levels, while it did not significantly alter T lymphocyte subpopulation counts, the rate of postoperative complications and the duration of hospital stay.
Gunerhan
Yusuf
Y
Department of Surgery, Kafkas University Faculty of Medicine, Pasacayiri 36100, Kars, Turkey. ygunerhan@gmail.com
Koksal
Neset
N
Sahin
Umit Yasar
UY
Uzun
Mehmet Ali
MA
Ekşioglu-Demiralp
Emel
E
D000368:Aged; D000369:Aged, 80 and over; D001120:Arginine / Q000008:administration & dosage; D005227:Fatty Acids / Q000008:administration & dosage; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000178:diet therapy / Q000276:immunology / Q000601:surgery; D006801:Humans; D007111:Immunity, Cellular; D018655:Lymphocyte Count; D016131:Lymphocyte Subsets / Q000276:immunology; D008297:Male; D008875:Middle Aged; D018448:Models, Immunological; D009711:Nucleotides / Q000008:administration & dosage; D018529:Nutritional Support / Q000379:methods*; D011300:Preoperative Care; D011446:Prospective Studies
D005227:Fatty Acids; D009711:Nucleotides; D001120:Arginine