Short-term preoperative supplementation of an immunoenriched diet does not improve clinical outcome in well-nourished patients undergoing abdominal cancer surgery.
OBJECTIVE
A recent study suggested that the anti-inflammatory effect of immunonutrition starts after only two d. We therefore investigated the effect of an immunoenriched oral diet administered for three d preoperatively.


METHODS
In this prospective, randomized, double-blind, placebo-controlled study, well-nourished patients (Nutrition Risk Screening 2002 <3) with gastrointestinal cancer who were scheduled for major elective abdominal cancer surgery were randomly assigned to either 750 mL of an immunoenriched formula (IEF group) or 750 mL of an isocaloric, isonitrogenous placebo diet (Con group) for 3 consecutive d preoperatively.


RESULTS
A total of 108 patients (IEF group: n = 55; Con group: n = 53) were randomized. The two groups were comparable for all baseline and surgical characteristics. The overall mortality was 2.8% and not significantly different between the two groups (IEF group: 3.6% vs. Con group: 1.9%, P = 1.00). Intention-to-treat analysis showed no difference for the incidence of postoperative overall (IEF group: 29% vs. Con group: 30%; P = 1.00) and infectious (IEF group: 15% vs. Con group: 17%; P = 0.79) complications. Length of hospital stay was 12 ± 4.9 d in the IEF group and 11.6 ± 5.3 d in the Con group (P = 0.68).


CONCLUSIONS
Preoperative oral supplementation with an immunoenriched diet for 3 d preoperatively did not improve postoperative outcome compared with the placebo in well-nourished patients with elective gastrointestinal cancer surgery.
Department of Surgery, Marienhospital Herne, Clinic of the Ruhr University Bochum, Germany. ursgiger@gmx.net
Urs
U
Giger-Pabst
Jochen
J
Lange
Christoph
C
Maurer
Carine
C
Bucher
Vital
V
Schreiber
Rolf
R
Schlumpf
Thomas
T
Kocher
Walter
W
Schweizer
Stephan
S
Krähenbühl
Lukas
L
Krähenbühl
D000368:Aged; D003428:Cross Infection / Q000453:epidemiology*; D004032:Diet; D019587:Dietary Supplements; D004311:Double-Blind Method; D017558:Elective Surgical Procedures / Q000401:mortality; D005260:Female; D005526:Food, Formulated; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000517:prevention & control; D057194:Intention to Treat Analysis; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D011183:Postoperative Complications / Q000453:epidemiology* / Q000276:immunology; D011300:Preoperative Care / Q000379:methods*