Favorable Effects of Preoperative Enteral Immunonutrition on a Surgical Site Infection in Patients with Colorectal Cancer Without Malnutrition

Overview

Journal Surg Today

Specialty General Surgery

Date 2006 Nov 24

PMID 17123134

Citations 30

Authors

Hisanaga Horie

Masaki Okada

Masayuki Kojima

Hideo Nagai

Affiliations

Soon will be listed here.

Abstract

Purpose: A prospective study was conducted to ascertain the effects of preoperative enteral immunonutrition on a surgical site infection (SSI) in patients with colorectal cancer without malnutrition.

Methods: Patients with colorectal cancer undergoing elective surgery without malnutrition, bowel obstruction, severe cardiopulmonary complications, diabetes, collagen disease, or renal failure were sequentially divided into an immunonutrition group (n = 33) and a control group (n = 34). In the immunonutrition group, an enteral diet supplemented with arginine, dietary nucleotides, and omega-3 fatty acids was administered for 5 days (750 ml/day) prior to surgery.

Results: The mean age was slightly higher in the immunonutrition group (69 +/- 9 years) than in the control group (63 +/- 11 years; P < 0.05), but no significant differences between the groups were noted for the body mass index, total protein, albumin, hemoglobin, surgical methods, operation time, or volume of intraoperative bleeding. The frequencies of superficial incisional SSI, deep incisional SSI and organ/space SSI in the immunonutrition and control groups were 0% and 11.8% (4/34; P < 0.05), 0% and 0%, and 0% and 2.9% (1/34), respectively.

Conclusion: Preoperative enteral immunonutrition appears to be effective for preventing SSI in patients with colorectal cancer without malnutrition.

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References

Farreras N, Artigas V, Cardona D, Rius X, Trias M, Gonzalez J . Effect of early postoperative enteral immunonutrition on wound healing in patients undergoing surgery for gastric cancer. Clin Nutr. 2005; 24(1):55-65. DOI: 10.1016/j.clnu.2004.07.002. View

Smith R, Bohl J, McElearney S, Friel C, Barclay M, Sawyer R . Wound infection after elective colorectal resection. Ann Surg. 2004; 239(5):599-605. PMC: 1356267. DOI: 10.1097/01.sla.0000124292.21605.99. View

Kirkland K, Briggs J, Trivette S, WILKINSON W, Sexton D . The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol. 1999; 20(11):725-30. DOI: 10.1086/501572. View

Braga M, Gianotti L, Nespoli L, Radaelli G, Di Carlo V . Nutritional approach in malnourished surgical patients: a prospective randomized study. Arch Surg. 2002; 137(2):174-80. DOI: 10.1001/archsurg.137.2.174. View

Braga M, Gianotti L, Vignali A, Di Carlo V . Preoperative oral arginine and n-3 fatty acid supplementation improves the immunometabolic host response and outcome after colorectal resection for cancer. Surgery. 2002; 132(5):805-14. DOI: 10.1067/msy.2002.128350. View

Rudolph F, Kulkarni A, Fanslow W, Pizzini R, Kumar S, Van Buren C . Role of RNA as a dietary source of pyrimidines and purines in immune function. Nutrition. 1990; 6(1):45-52; discussion 59-62. View

Reynolds J, Daly J, Shou J, Sigal R, ZIEGLER M, Naji A . Immunologic effects of arginine supplementation in tumor-bearing and non-tumor-bearing hosts. Ann Surg. 1990; 211(2):202-10. PMC: 1357965. DOI: 10.1097/00000658-199002000-00013. View

Barbul A . Arginine and immune function. Nutrition. 1990; 6(1):53-8; discussion 59-62. View

. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control. 2004; 32(8):470-85. DOI: 10.1016/S0196655304005425. View

10.

Gianotti L, Braga M, Nespoli L, Radaelli G, Beneduce A, Di Carlo V . A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. Gastroenterology. 2002; 122(7):1763-70. DOI: 10.1053/gast.2002.33587. View

11.

Mangram A, Horan T, Pearson M, Silver L, Jarvis W . Guideline for prevention of surgical site infection, 1999. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol. 1999; 20(4):250-78; quiz 279-80. DOI: 10.1086/501620. View

12.

Weimann A, Bastian L, Bischoff W, Grotz M, Hansel M, Lotz J . Influence of arginine, omega-3 fatty acids and nucleotide-supplemented enteral support on systemic inflammatory response syndrome and multiple organ failure in patients after severe trauma. Nutrition. 1998; 14(2):165-72. DOI: 10.1016/s0899-9007(97)00429-2. View

13.

Grimble G . Dietary nucleotides and gut mucosal defence. Gut. 1994; 35(1 Suppl):S46-51. PMC: 1378147. DOI: 10.1136/gut.35.1_suppl.s46. View

14.

Gottschlich M . Selection of optimal lipid sources in enteral and parenteral nutrition. Nutr Clin Pract. 1992; 7(4):152-65. DOI: 10.1177/0115426592007004152. View

15.

Sumiyama Y . [Guidelines for perioperative antibiotic use in digestive tract surgery]. Nihon Geka Gakkai Zasshi. 2002; 102(12):856-9. View

16.

Kinsella J, Lokesh B, Broughton S, Whelan J . Dietary polyunsaturated fatty acids and eicosanoids: potential effects on the modulation of inflammatory and immune cells: an overview. Nutrition. 1990; 6(1):24-44; discussion 59-62. View

17.

Coello R, Charlett A, Wilson J, Ward V, Pearson A, Borriello P . Adverse impact of surgical site infections in English hospitals. J Hosp Infect. 2005; 60(2):93-103. DOI: 10.1016/j.jhin.2004.10.019. View

18.

Cynober L . Can arginine and ornithine support gut functions?. Gut. 1994; 35(1 Suppl):S42-5. PMC: 1378146. DOI: 10.1136/gut.35.1_suppl.s42. View

19.

Horan T, Gaynes R, Martone W, Jarvis W, Emori T . CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol. 1992; 13(10):606-8. View

20.

Konishi T, Harihara Y, Morikane K . [Surgical site infection surveillance]. Nihon Geka Gakkai Zasshi. 2004; 105(11):720-5. View