M. Braga et al., BENEFITS OF EARLY POSTOPERATIVE ENTERAL FEEDING IN CANCER-PATIENTS, Infusionstherapie und Transfusionsmedizin, 22(5), 1995, pp. 280-284
Objective: To evaluate the effect of the early postoperative administr
ation of an enriched enteral diet in cancer patients. Design: Randomis
ed controlled study. Setting: Surgical intensive care unit of a univer
sity hospital. Patients: 77 consecutive patients undergoing curative s
urgery for gastric or pancreatic cancer. Interventions: Patients were
randomised into 3 groups to receive: a standard enteral formula (n = 2
4); the same formula enriched with arginine, RNA, and omega-3 fatty ac
ids (n = 26); isonitrogen isocaloric total parenteral nutrition (n = 2
7). Enteral nutrition was started within 12 h following surgery. Infus
ion rate was progressively increased reaching the full regimen on post
operative day (POD) 4. On admission and on POD 1 and 8, the following
measurements were performed: serum level of total iron-binding capacit
y, albumin, prealbumin, retinol-binding protein (REP), and cholinester
ase. Delayed hypersensitivity response (DHR), IgG, IgM, IgA, lymphocyt
e subsets, and monocyte phagocytosis ability were also evaluated. Bioe
lectrical impedance analysis was performed preoperatively and on POD 2
, 7, and 11. The rate and severity of postoperative infections and the
length of hospital stay were evaluated. Results: In all patients, a s
ignificant drop of nutritional and immunologic parameters was observed
on POD 1. A significant increase of prealbumin (p<0.02), REP (p<0.005
), monocyte phagocytosis ability (p<0.001), and DHR (p<0.005) was foun
d on POD 8 only in the group fed with the enriched diet. A significant
reduction of severity of postoperative infections and length of posto
perative stay was found in the group with the enriched diet compared t
o the other groups.Conclusions: These data are suggestive of an improv
ement of the nutritional and immunologic status and clinical outcome i
n cancer patients who receive an enriched enteral diet in the early po
stoperative course.