title: A randomized double-blind clinical trial with two different doses of arginine enhanced enteral nutrition in postsurgical cancer patients.
abstract: OBJECTIVE
  Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using an enteral high dose of arginine (20 g per day) vs a medium dose (12.3 g per day) could improve nutritional variables as well as clinical outcome.
  
  
  METHODS
  A population of 115 patients with oral and laryngeal cancer was enrolled. At surgery patients were randomly allocated to two groups: group I (58 patients) received an enteral diet supplements with a high dose of arginine (20 g per day) and group II (57 patients) received an isocaloric, isonitrogenous enteral formula with a medium dose of arginine (12.3 g per day).
  
  
  RESULTS
  Gastrointestinal tolerance (diarrhea) of both formulas was good (3.44% group I and 3.51% group II: ns). The postoperative infections complications were similar in both groups (8.6% group I and 12.2% group II: ns). Fistula was less frequent in enriched nutrition group (3.4% group I and 10.5% group II: p = 0.006). The length of postoperative stay was similar in both groups (27.2 +/- 17.8 days in group I vs 25.7 +/- 18.8 days in group II: ns).
  
  
  CONCLUSIONS
  Enriched arginine formula improves fistula wound complications in postoperative head and neck cancer patients. Our results suggest that these patients could benefit from a high dose of arginine enhanced enteral formula.
authors.affiliation: Institute of Endocrinology and Nutrition, Medicine School and Hospital Rio Hortega, University of Valladolid, Valladolid, Spain. dadluis@yahoo.es
authors.forename: D A
authors.initials: DA
authors.lastname: De Luis
authors.forename: O
authors.initials: O
authors.lastname: Izaola
authors.forename: L
authors.initials: L
authors.lastname: Cuellar
authors.forename: M C
authors.initials: MC
authors.lastname: Terroba
authors.forename: T
authors.initials: T
authors.lastname: Martin
authors.forename: M
authors.initials: M
authors.lastname: Ventosa
mesh_terms: D000328:Adult; D000368:Aged; D001120:Arginine / Q000008:administration & dosage*; D004311:Double-Blind Method; D004750:Enteral Nutrition; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D013530:Surgical Wound Infection / Q000517:prevention & control
chemical_list: D001120:Arginine