title: Is preoperative protein-rich nutrition effective on postoperative outcome in non-small cell lung cancer surgery? A prospective randomized study.
abstract: OBJECTIVE
  Protein-rich nutrition is necessary for wound healing after surgery. In this study, the benefit of preoperative nutritional support was investigated for non-small cell lung cancer patients who underwent anatomic resection.
  
  
  METHODS
  A prospective study was planned with the approval of our institutional review board. Fifty-eight patients who underwent anatomic resection in our department between January 2014 and December 2014 were randomized. Thirty-one patients were applied a preoperative nutrition program with immune modulating formulae (enriched with arginine, omega-3 fatty acids and nucleotides) for ten days. There were 27 patients in the control group who were fed with only normal diet. Patients who were malnourished, diabetic or who had undergone bronchoplastic procedures or neoadjuvant therapy were excluded from the study. Patients' baseline serum albumin levels, defined as the serum albumin level before any nutrition program, and the serum albumin levels on the postoperative third day were calculated and recorded with the other data.
  
  
  RESULTS
  Anatomic resection was performed by thoracotomy in 20 patients, and 11 patients were operated by videothoracoscopy in the nutrition program group. On the other hand 16 patients were operated by thoracotomy and 11 patients were operated by videothoracoscopy in the control group. In the control group, the patients' albumin levels decreased to 25.71 % of the baseline on the postoperative third day, but this reduction was only 14.69 % for nutrition program group patients and the difference was statistically significant (p < 0.001). Complications developed in 12 patients (44.4 %) in the control group compared to 6 patients in the nutrition group (p = 0.049). The mean chest tube drainage time was 6 (1-42) days in the control group against 4 (2-15) days for the nutrition program group (p = 0.019).
  
  
  CONCLUSIONS
  Our study showed that preoperative nutrition is beneficial in decreasing the complications and chest tube removal time in non-small cell lung cancer patients that were applied anatomic resection with a reduction of 25 % in the postoperative albumin levels of non-malnourished patients who underwent resection.
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Seyda Ors
authors.initials: SO
authors.lastname: Kaya
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey. tevfikilkerakcam@hotmail.com.
authors.forename: Tevfik Ilker
authors.initials: TI
authors.lastname: Akcam
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Kenan Can
authors.initials: KC
authors.lastname: Ceylan
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Samancılar
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Ozturk
authors.affiliation: Department of Thoracic Surgery, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Ozan
authors.initials: O
authors.lastname: Usluer
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000601:surgery*; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D018529:Nutritional Support / Q000379:methods; D011183:Postoperative Complications; D011184:Postoperative Period; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies; D012709:Serum Albumin / Q000378:metabolism; D020775:Thoracic Surgery, Video-Assisted / Q000009:adverse effects / Q000379:methods; D013908:Thoracotomy / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome
chemical_list: D012709:Serum Albumin