title: Effect of a Perioperative Nutritional Supplementation with Oral Impact® in Patients undergoing Hepatic Surgery for Liver Cancer: A Prospective, Placebo-Controlled, Randomized, Double-Blind Study.
abstract: Perioperative nutrition with supplements containing L-arginine, ω3-polyunsaturated fatty acids, and nucleotides could boost liver function recovery, immune response, and resistance to infection after hepatic resection. We conducted a placebo-controlled, randomized, double-blind study to assess the effect of a perioperative nutritional supplementation with Oral Impact® in patients undergoing hepatic surgery for liver cancer. Treatment was given three times daily for 7 days before and 3 days after surgery. Primary outcome was factor V, 3 days after surgery. Thirty-five patients (placebo: 17; Oral Impact: 18) were included. Five patients (placebo: three; Oral Impact: two) were not operated and five (placebo: two; Oral Impact: three) did not undergo hepatic resection. Factor V (mean ± SD) was 70 ± 27% and 79 ± 25% (P = 0.409) 3 days after surgery and 90 ± 30% and 106 ± 16% (P = 0.066) 5 days after surgery, in placebo and Oral Impact groups, respectively. There were no significant differences between groups on other outcomes assessing liver function recovery (bile production, γ-glutamyl transferase, α-fetoprotein), immune response (CD3, CD4, CD8 cells, CD4/CD8 ratio, natural killer cells, B lymphocytes), number of infections, and tolerance. A 10-day perioperative nutritional supplementation with Oral Impact does not improve hepatic function, immune response, and resistance to infection in patients undergoing hepatic surgery for liver cancer.
authors.affiliation: a Department of Surgical Intensive Care , Rennes University Hospital, Rennes 1 University , Rennes , France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Seguin
authors.affiliation: b Department of Clinical Pharmacology , Inserm 0203, Clinical Investigation Centre, Rennes University Hospital, Rennes 1 University , Rennes , France.
authors.forename: Clara
authors.initials: C
authors.lastname: Locher
authors.affiliation: c Department of Liver and Digestive Surgery , Rennes University Hospital, Rennes 1 University , Rennes , France.
authors.forename: Karim
authors.initials: K
authors.lastname: Boudjema
authors.affiliation: d Department of Pharmacy , Rennes University Hospital, Rennes 1 University , Rennes , France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Hamon
authors.affiliation: b Department of Clinical Pharmacology , Inserm 0203, Clinical Investigation Centre, Rennes University Hospital, Rennes 1 University , Rennes , France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Mouchel
authors.affiliation: a Department of Surgical Intensive Care , Rennes University Hospital, Rennes 1 University , Rennes , France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Malledant
authors.affiliation: b Department of Clinical Pharmacology , Inserm 0203, Clinical Investigation Centre, Rennes University Hospital, Rennes 1 University , Rennes , France.
authors.forename: Eric
authors.initials: E
authors.lastname: Bellissant
mesh_terms: D000284:Administration, Oral; D000368:Aged; D015415:Biomarkers / Q000097:blood; D019587:Dietary Supplements / Q000009:adverse effects; D005165:Factor V / Q000032:analysis; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D019990:Perioperative Care / Q000379:methods*; D010919:Placebos; D011183:Postoperative Complications / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D010919:Placebos; D005165:Factor V