title: Postoperative hypocaloric peripheral parenteral nutrition with branched-chain-enriched amino acids provides no better clinical advantage than fluid management in nonmalnourished colorectal cancer patients.
abstract: To assess clinical efficacy of using postoperative branched-chain amino acids (BCAAs)-enriched nutritional support in lower gastrointestinal cancer patients, we conducted a retrospective observational study comparing this regimen with traditional fluid management. Sixty-one eligible colorectal cancer patients consecutively admitted in the Colorectal Surgery Ward to receive postoperative hypocaloric peripheral parenteral nutrition (HPPN) were categorized into dextrose-only control group (n = 20), dextrose plus low-dose BCAA fat group (n = 20), and dextrose plus high-dose BCAA fat group (n = 21). Nutritional, clinical, and biochemical outcomes were collected on the day before and 7 days after surgery. Patients were nonmalnourished. Over the 7-day observation period, the control group had a significantly higher reduction in body mass index than the lower dose and the higher dose BCAA groups (P = 0.023 and P = 0.002, respectively). Compared to high-dose BCAA group, the control group also had a lower nitrogen excretion (P < 0.0001) and less reduction in nitrogen balance (P < 0.0001). There were no differences between study groups in biochemical measures, phlebitis, postoperative hospital stay, and in-hospital mortality. We found no better clinical advantage to the postoperative administration of BCAA-enriched HPPN than fluid management in nonmalnourished colorectal cancer patients.
authors.affiliation: a Department of Dietetics and Nutrition, Taipei Veterans General Hospital , Taipei City , Taiwan.
authors.forename: Hsiu-Hua
authors.initials: HH
authors.lastname: Huang
authors.forename: Pi-Chuan
authors.initials: PC
authors.lastname: Wu
authors.forename: Shiu-Ping
authors.initials: SP
authors.lastname: Kang
authors.forename: Jui-Ho
authors.initials: JH
authors.lastname: Wang
authors.forename: Chien-Wei
authors.initials: CW
authors.lastname: Hsu
authors.forename: Leh-Chii
authors.initials: LC
authors.lastname: Chwang
authors.forename: Sue-Joan
authors.initials: SJ
authors.lastname: Chang
mesh_terms: D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000597:Amino Acids, Branched-Chain / Q000008:administration & dosage*; D001663:Bilirubin / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000601:surgery / Q000628:therapy*; D004041:Dietary Fats / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D005260:Female; D005947:Glucose / Q000008:administration & dosage; D006801:Humans; D008214:Lymphocytes / Q000166:cytology / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods*; D011184:Postoperative Period; D064167:Recommended Dietary Allowances; D012189:Retrospective Studies; D012709:Serum Albumin / Q000378:metabolism; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D000597:Amino Acids, Branched-Chain; D001786:Blood Glucose; D004041:Dietary Fats; D004044:Dietary Proteins; D012709:Serum Albumin; D014280:Triglycerides; D000410:Alanine Transaminase; D005947:Glucose; D001663:Bilirubin