title: Effects of a preoperative immune-modulating diet in patients with esophageal cancer: a prospective parallel group randomized study.
abstract: OBJECTIVE
  The aim of this pilot study was to investigate the effects of a preoperative immune-modulating diet (IMD) before thoracoscopic esophagectomy for patients with esophageal cancer.
  
  
  METHODS
  Thirty patients who were diagnosed with resectable esophageal cancer were assigned to two groups: the IMD (n = 15) and the standard liquid diet (SLD; n = 15) groups. We evaluated postoperative parameters, such as the incidence of complications and the postoperative levels of cytokines as the primary endpoints. The secondary endpoint was the length of hospital stay.
  
  
  RESULTS
  The peak levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α appeared on postoperative day (POD) 1 and POD 2 in the IMD and SLD group, respectively. The peak level of C-reactive protein (CRP) appeared on POD 3 in both groups (IMD 9.9 mg/dL, SLD 15.2 mg/dL). Overall, TNF-α levels in the IMD group were lower than those in the SLD group (P = 0.033). Furthermore, IL-6 (P = 0.182) and CRP (P = 0.191) levels, and the incidence of postoperative pneumonia (7.1 vs. 26.7%; P = 0.330) tended to be lower in the IMD group than in the SLD group.
  
  
  CONCLUSIONS
  Preoperative IMD suppressed the elevation of the TNF-α levels after thoracoscopic esophagectomy in patients with esophageal cancer, although no different tendency was detected in terms of IL-6, CRP or postoperative complications.
authors.affiliation: Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitagawa
authors.affiliation: Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan. tsutomun@kochi-u.ac.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Namikawa
authors.affiliation: Department of Anesthesiology, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan.
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Yatabe
authors.affiliation: Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Munekage
authors.affiliation: Department of Clinical Laboratory, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan.
authors.forename: Fumiyasu
authors.initials: F
authors.lastname: Yamasaki
authors.affiliation: Department of Human Health and Medical Sciences, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan.
authors.forename: Michiya
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hanazaki
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D016207:Cytokines / Q000097:blood; D004032:Diet; D004938:Esophageal Neoplasms / Q000097:blood / Q000178:diet therapy* / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D056747:Immunomodulation; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D013906:Thoracoscopy
chemical_list: D016207:Cytokines; D002097:C-Reactive Protein
keywords: Esophageal cancer; Esophagectomy; Immune-modulating diet; Preoperative nutrition