June 28, 2002
Preoperative supplementation with oral immunonutrition in gastric cancer patients halved postoperative infections and shortened hospital stays compared with standard care,
according to results of a randomized trial reported in the June issue of Gastroenterology. “Preoperative supplementation is as effective as perioperative administration in improving outcome,” write Luca Gianotti and colleagues from the University of Milan in Italy. “Both strategies seem superior to the conventional approach.”
The investigators randomized 305 patients with gastrointestinal cancer and less than 10% preoperative weight loss to three groups. The preoperative group received oral supplementation for five days before surgery with 1 L/day of formula enriched with arginine, omega-3 fatty acids, and RNA. The perioperative group also received postoperative jejunal infusion with the same enriched formula, and the conventional group received no artificial nutrition before or after surgery. The groups were well matched for clinical and surgical characteristics.
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