D A de Luis1, O Izaola, L Cuellar, M C Terroba, R Aller. 1. Institute of Endocrinology and Nutrition, Medicine School and Unit of Investigation, Hospital Rio Hortega, University of Valladolid, Valladolid, Spain. dadluis@yahoo.es
Abstract
OBJECTIVE:Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients using an arginine-enhanced formula could improve nutritional variables as well as clinical outcomes. DESIGN: Randomized clinical trial. SETTING: Tertiary care. SUBJECTS: A population of 90 patients with oral and laryngeal cancer was enrolled. INTERVENTIONS: At surgery, patients were randomly allocated to two groups: (a) patients receiving an arginine-enhanced formula with arginine and fiber (group I) and (b) patients receiving an isocaloric, isonitrogenous formula with fiber enteral formula (group II). RESULTS: No significant intergroup differences in the trend of the three plasma proteins (albumin, transferrin, prealbumin) and lymphocytes were detected. Gastrointestinal tolerance (diarrhea) was better in group II than I (40% group I and 13% group II: P<0.05). The postoperative complications due to infections were similar in both groups (4% group I and 9% group II: ns). Fistula (wound complication) was less frequent in the enriched nutrition group (5% group I and 11% group II: P<0.05); wound infection was similar in both groups. The length of postoperative stay was better in group I than II (25.8+/-15 days vs 35+/-24.6 days; P<0.05). CONCLUSIONS: In conclusion, arginine-enhanced formula improves fistula rates in postoperative head and neck cancer patients and decreases length of stay.
RCT Entities:
OBJECTIVE:Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancerpatients using an arginine-enhanced formula could improve nutritional variables as well as clinical outcomes. DESIGN: Randomized clinical trial. SETTING: Tertiary care. SUBJECTS: A population of 90 patients with oral and laryngeal cancer was enrolled. INTERVENTIONS: At surgery, patients were randomly allocated to two groups: (a) patients receiving an arginine-enhanced formula with arginine and fiber (group I) and (b) patients receiving an isocaloric, isonitrogenous formula with fiber enteral formula (group II). RESULTS: No significant intergroup differences in the trend of the three plasma proteins (albumin, transferrin, prealbumin) and lymphocytes were detected. Gastrointestinal tolerance (diarrhea) was better in group II than I (40% group I and 13% group II: P<0.05). The postoperative complications due to infections were similar in both groups (4% group I and 9% group II: ns). Fistula (wound complication) was less frequent in the enriched nutrition group (5% group I and 11% group II: P<0.05); wound infection was similar in both groups. The length of postoperative stay was better in group I than II (25.8+/-15 days vs 35+/-24.6 days; P<0.05). CONCLUSIONS: In conclusion, arginine-enhanced formula improves fistula rates in postoperative head and neck cancerpatients and decreases length of stay.
Authors: Lucas W Thornblade; Thomas K Varghese; Xu Shi; Eric K Johnson; Amir Bastawrous; Richard P Billingham; Richard Thirlby; Alessandro Fichera; David R Flum Journal: Dis Colon Rectum Date: 2017-01 Impact factor: 4.585
Authors: Amy Turnock; Philip C Calder; Annette L West; Mark Izzard; Randall P Morton; Lindsay D Plank Journal: Nutrients Date: 2013-04-09 Impact factor: 5.717