Hiroyuki Kitagawa1, Tsutomu Namikawa2, Tomoaki Yatabe3, Masaya Munekage1, Fumiyasu Yamasaki4, Michiya Kobayashi5, Kazuhiro Hanazaki1. 1. Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan. 2. Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan. tsutomun@kochi-u.ac.jp. 3. Department of Anesthesiology, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan. 4. Department of Clinical Laboratory, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan. 5. Department of Human Health and Medical Sciences, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan.
Abstract
PURPOSE: 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.
RCT Entities:
PURPOSE: 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.
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