title: Parenteral glutamine supplement has synergic effects in minimally invasive surgery of subtotal gastrectomy patients.
abstract: OBJECTIVE
  Exogenous glutamine supplement is known to improve morbidity and mortality of critically-ill patients. This study was conducted to elucidate the role of glutamine in minimally invasive surgery.
  
  
  METHODS
  We retrospectively reviewed subtotal gastrectomy patients in National Taiwan University Hospital from Dec 2005 to Dec 2008. The patients were divided into three groups. Group 1 underwent subtotal gastrectomy by laparotomy without glutamine supplement, group 2 underwent subtotal gastrectomy by laparotomy with glutamine supplement and group 3 underwent gasless laparoscopy-assisted subtotal gastrectomy with parenteral glutamine supplement.
  
  
  RESULTS
  There were 155 patients in total; 85 patients in group 1, 17 in group 2 and 53 in group 3. The mean flatus days after operation are 3.6, 3.1 and 2.8 for groups 1, 2 and 3, respectively (p=0.001). Oral intake after operation was commenced after 6.7, 5.0 and 4.7 days (p=0.006). The body temperature had borderline differences between groups 3 and 1. There were significant differences in postoperative systemic responses including heart rates (p<0.001) and tenderness (p=0.011) 5 days after operation for group 3 vs. group 1. Minimally invasive surgery was a negative factor for postoperative body temperature change. Glutamine was a significant factor for postoperative heart rate change and reduction of tenderness.
  
  
  CONCLUSIONS
  Glutamine supplement may have synergic effects of rapid recovery in minimal invasive surgery for subtotal gastrectomy patients by minimizing the postoperative systemic response and accelerating recovery.
authors: Department of Surgery, National Taiwan University Hospital, Taipei, Republic of China.
authors: Chien-Chia
authors: CC
authors: Chen
authors: Tung-Cheng
authors: TC
authors: Chang
authors: Ming-Yang
authors: MY
authors: Wang
authors: Ming-Hsun
authors: MH
authors: Wu
authors: Ming-Tsan
authors: MT
authors: Lin
mesh_terms: D000368:Aged; D001833:Body Temperature Regulation; D019587:Dietary Supplements; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D005973:Glutamine / Q000008:administration & dosage*; D006339:Heart Rate; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D011183:Postoperative Complications / Q000209:etiology; D020127:Recovery of Function; D012189:Retrospective Studies; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005973:Glutamine