Optimal dose of preoperative enteral immunonutrition for patients with esophageal cancer.
OBJECTIVE
A preoperative immunonutrition pharmaceutics diet (IMPACT) significantly reduced the incidence of postoperative infectious complications, but the optimal regimen still remains unclear. We evaluated the optimal dose of a preoperative IMPACT for patients with esophageal carcinoma and the incidence of postoperative complications based on the dose of IMPACT.


METHODS
This study design was a prospective nonrandomized study. Twenty patients with thoracic esophageal carcinoma who underwent a right transthoracic subtotal esophagectomy were divided into two groups. These patients were administered immunonutrition of 500 ml/day (IMP500) or 1000 ml/day (IMP1000) for 7 days before the operation.


RESULTS
The incidence of postoperative mortality and morbidity was not different between the IMP500 group and the IMP1000 group. No difference was observed in the perioperative changes in inflammatory, immunological and nutritional variables between the two groups. There were no adverse effects in the IMP500 group, but four patients (40%) had diarrhea and four patients (40%) had appetite loss in the IMP1000 group. In the IMP1000 group, only four patients (40%) could take 1000 ml, but others reduced the quantity of IMPACT because of diarrhea and discomfort.


CONCLUSIONS
This study suggests that 500 ml of IMPACT is recommended as an optimal dose for patients with esophageal cancer.
Second Department of Surgery, School of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama 641-8510, Japan.
Masaki
M
Nakamura
Makoto
M
Iwahashi
Katsunari
K
Takifuji
Mikihito
M
Nakamori
Teiji
T
Naka
Koichiro
K
Ishida
Toshiyasu
T
Ojima
Takeshi
T
Iida
Masahiro
M
Katsuda
Keiji
K
Hayata
Hiroki
H
Yamaue
D015126:8,11,14-Eicosatrienoic Acid / Q000097:blood; D000368:Aged; D016718:Arachidonic Acid / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D004281:Docosahexaenoic Acids / Q000097:blood; D004306:Dose-Response Relationship, Immunologic; D015118:Eicosapentaenoic Acid / Q000097:blood; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D004938:Esophageal Neoplasms / Q000276:immunology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D018655:Lymphocyte Count; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control; D011300:Preoperative Care; D011446:Prospective Studies; D012709:Serum Albumin / Q000032:analysis; D016896:Treatment Outcome
D015850:Interleukin-6; D012709:Serum Albumin; D004281:Docosahexaenoic Acids; D016718:Arachidonic Acid; D002097:C-Reactive Protein; D015118:Eicosapentaenoic Acid; D015126:8,11,14-Eicosatrienoic Acid