title: Randomized clinical trial of intravenous soybean oil alone versus soybean oil plus fish oil emulsion after gastrointestinal cancer surgery.
abstract: BACKGROUND
  Specific immunonutrients may reduce the incidence of postoperative complications and shorten recovery time. This randomized trial evaluated the clinical efficacy of a fish oil emulsion on outcome and immune function after gastrointestinal cancer surgery.
  
  
  METHODS
  A total of 206 patients with gastrointestinal or colonic cancer were randomized to receive isocaloric and isonitrogenous intravenous infusions of either soybean oil alone (1.2 g per kg bodyweight per day; control group, 103 analysed) or soybean plus fish oil emulsion (1.0 and 0.2 g per kg per day respectively; treatment group, 100 analysed) over 20-24 h daily for 7 days after surgery.
  
  
  RESULTS
  Baseline data were comparable in the two groups. There were fewer infectious complications (four versus 12 on day 8; P = 0.066), systemic inflammatory response syndrome (SIRS) was significantly less common (four versus 13; P = 0.039) and hospital stay was significantly shorter (mean(s.d.) 15(5) versus 17(8) days; P = 0.041) in the treatment group. Total postoperative medical costs were comparable in the two groups (mean(s.d.) US $ 1269(254) and 1302(324) in treatment and control groups respectively; P = 0.424). The median (interquartile range) difference in CD4/CD8 between days 1 and 8 after surgery was + 0.30 (0.06 to 0.79) in patients receiving fish oil and + 0.20 (-0.19 to 0.55) in controls (P = 0.021). No severe adverse events occurred in either group.
  
  
  CONCLUSIONS
  Fish oil emulsion-supplemented parenteral nutrition significantly reduced SIRS and length of hospital stay. These clinical benefits may be related to normalization of cellular immune functions and modulation of the inflammatory response.
authors.affiliation: Department of Surgery and Parenteral and Enteral Nutrition, and Centre for Parenteral and Enteral Nutrition, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences. jiangzm@imicams.ac.cn
authors.forename: Z M
authors.initials: ZM
authors.lastname: Jiang
authors.forename: D W
authors.initials: DW
authors.lastname: Wilmore
authors.forename: X R
authors.initials: XR
authors.lastname: Wang
authors.forename: J M
authors.initials: JM
authors.lastname: Wei
authors.forename: Z T
authors.initials: ZT
authors.lastname: Zhang
authors.forename: Z Y
authors.initials: ZY
authors.lastname: Gu
authors.forename: S
authors.initials: S
authors.lastname: Wang
authors.forename: S M
authors.initials: SM
authors.lastname: Han
authors.forename: H
authors.initials: H
authors.lastname: Jiang
authors.forename: K
authors.initials: K
authors.lastname: Yu
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D001835:Body Weight; D016516:CD4-CD8 Ratio; D003110:Colonic Neoplasms / Q000276:immunology / Q000601:surgery; D003362:Cost-Benefit Analysis; D004655:Emulsions; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D005770:Gastrointestinal Neoplasms / Q000276:immunology / Q000601:surgery*; D006801:Humans; D007262:Infusions, Intravenous; D015850:Interleukin-6 / Q000378:metabolism; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000209:etiology / Q000276:immunology; D012141:Respiratory Tract Infections / Q000209:etiology / Q000276:immunology; D013024:Soybean Oil / Q000008:administration & dosage* / Q000191:economics; D013530:Surgical Wound Infection / Q000209:etiology / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014552:Urinary Tract Infections / Q000209:etiology / Q000276:immunology
chemical_list: D004655:Emulsions; D005395:Fish Oils; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D013024:Soybean Oil