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Immunonutrition AND Surgery

Selim Yiğit Yildiz, Murat Burç Yazicioğlu, Çağrı Tiryaki, Ali Çiftçi, Zehra Boyacioğlu
BACKGROUND/AIM: Enteral feeding and immunonutrition (ImN) have been shown to be associated with a number of favorable effects in patients undergoing cancer surgery. In this prospective study, we aimed to assess the perioperative use of enteral immunonutrition in patients undergoing radical gastrointestinal surgery for malignancy. MATERIALS AND METHODS: Forty-one patients with malignancy were included in this study and were randomized into one of the two following nutritional strategies: enteral only (EN) or enteral with enteral immunonutrition (ENIN)...
2016: Turkish Journal of Medical Sciences
Audrey Machado Dos Reis, Geórgia Brum Kabke, Ana Valéria Gonçalves Fruchtenicht, Taiane Dias Barreiro, Luis Fernando Moreira
INTRODUCTION: Costs, length of hospital staying and morbidity are frequently and significantly increased as a result of infections and other complications following surgical procedure for gastrointestinal tract cancer. Recently, improving host defence mechanisms have become a target of interest. Immunonutrition aims at improving immunity, most likely providing key nutrients to maintain T-lymphocyte and other host defence. AIM: To evaluate the immunonutrition in cancer patients who are operated by digestive diseases and assess the cost-effectiveness of this supplementation...
April 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Fumihiro Shoji, Yosuke Morodomi, Takaki Akamine, Shinkichi Takamori, Masakazu Katsura, Kazuki Takada, Yuzo Suzuki, Takatoshi Fujishita, Tatsuro Okamoto, Yoshihiko Maehara
BACKGROUND: The most effective treatment for early-stage non-small cell lung cancer (NSCLC) is surgical resection. Nevertheless, up to 20% of patients, even those with stage I NSCLC, relapse after surgery and die. The prognostic nutritional index (PNI) is used to assess immunonutritional conditions or is a predictor of postoperative recurrence in patients with digestive malignancies. However, the usefulness of the PNI for lung cancer is still unknown. We retrospectively analyzed clinicopathological features of stage I NSCLC patients to identify predictors of recurrence and to investigate effects of preoperative PNI levels...
August 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Yuanfeng Gong, Zhaohui Liu, Yadi Liao, Cong Mai, Tiejun Chen, Hui Tang, Yunqiang Tang
OBJECTIVE: The present study aimed to investigate the effectiveness of parenteral nutritional support with ω-3 PUFAs-based lipid emulsions in patients after liver resection. METHODS: A total of 119 patients were randomly assigned to the immunonutrition (IM) group (n = 59) and control group (n = 60). The IM group was continuously given Omegaven(®) 10% 100 mL/day rather than regular nutrition for five days postoperatively. Venous blood samples were obtained from all subjects before surgery and D1, D3 and D7 after surgery...
2016: Nutrients
S Silvestri, A Franchello, G Deiro, R Galletti, D Cassine, D Campra, D Bonfanti, L De Carli, F Fop, G R Fronda
BACKGROUND: Pancreaticoduodenectomy is still associated to high morbility, especially due to pancreatic surgery related and infectious complications: many risk factors have already been advocated. Aim of this study is to evaluate the role of preoperative oral immunonutrition in well nourished patients scheduled for pancreaticoduodenectomy. METHODS: From February 2014 to June 2015, 54 well nourished patients undergoing pancreaticoduodenectomy were enrolled for 5 days preoperative oral immunonutrition...
July 2016: International Journal of Surgery
Pedro Moya, Leticia Soriano-Irigaray, Jose Manuel Ramirez, Alessandro Garcea, Olga Blasco, Francisco Javier Blanco, Carlo Brugiotti, Elena Miranda, Antonio Arroyo
To compare immunonutrition versus standard high calorie nutrition in patients undergoing elective colorectal resection within an Enhanced Recovery After Surgery (ERAS) program.Despite progress in recent years in the surgical management of patients with colorectal cancer (ERAS programs), postoperative complications are frequent. Nutritional supplements enriched with immunonutrients have recently been introduced into clinical practice. However, the extent to which the combination of ERAS protocols and immunonutrition benefits patients undergoing colorectal cancer surgery is unknown...
May 2016: Medicine (Baltimore)
Shishira Bharadwaj, Brandon Trivax, Parul Tandon, Bilal Alkam, Ibrahim Hanouneh, Ezra Steiger
Postoperative infectious complications are independently associated with increased hospital length of stay (LOS) and cost and contribute to significant inpatient morbidity. Many strategies such as avoidance of long periods of preoperative fasting, re-establishment of oral feeding as early as possible after surgery, metabolic control and early mobilization have been used to either prevent or reduce the incidence of postoperative infections. Despite these efforts, it remains a big challenge to our current healthcare system to mitigate the cost of postoperative morbidity...
May 2016: Gastroenterology Report
Miguel Aprelino Alito, José Eduardo de Aguilar-Nascimento
BACKGROUND: Multimodal protocols of perioperative care may enhance postoperative recovery. However, limited information is available on preoperative immune and carbohydrate (CHO)-enriched drinks in patients undergoing hip arthroplasty. We aimed to investigate the effect of a multimodal protocol (ACERTO protocol) plus preoperative immune nutrition on the length of stay (LOS) and the postoperative acute phase response of patients undergoing total hip arthroplasty. METHODS: Thirty-two patients (mean age, 58 years; range, 26-85 years; 16 males) were randomized to receive either the ACERTO protocol (n = 15, ACERTO Group), which consisted of 6 h preoperative fasting for solids, an oral drink (200 mL of 12...
2016: Nutrition Journal
Chee S Wong, Emad H Aly
AIM: The beneficial of immunonutrition on overall morbidity and mortality remains uncertain. We undertook a systematic review to evaluate the effects of immune-enhancing enteral nutrition (IEN) in upper gastrointestinal (GI) surgery. METHODS: Main electronic databases [MEDLINE via Pubmed, EMBASE, Scopus, Web of Knowledge, Cochrane Central Register of Controlled Trials (CENTRAL) and the Cochrane Library, and clinical trial registry (] were searched for studies reported clinical outcomes comparing standard enteral nutrition (SEN) and immunonutrition (IEN)...
May 2016: International Journal of Surgery
Pascal Probst, Daniel Keller, Johannes Steimer, Emanuel Gmür, Alois Haller, Reinhard Imoberdorf, Maya Rühlin, Hans Gelpke, Stefan Breitenstein
BACKGROUND: Suggested guidelines for nutritional support after pancreaticoduodenectomy are still controversial. Recent evidence suggests that combining enteral nutrition (EN) with parenteral nutrition (PN) improves outcome. For ten years, patients have been treated with Early Combined Parenteral and Enteral Nutrition (ECPEN) after PD. The aim of this study was to report on rationale, safety, effectiveness and outcome associated with this method. METHODS: Consecutive PD performed between 2003 and 2012 were analyzed retrospectively...
March 2016: Annals of Medicine and Surgery
Josephine Gade, Trine Levring, Jens Hillingsø, Carsten Palnæs Hansen, Jens Rikardt Andersen
Major gastrointestinal surgery is associated with immune suppression and a high risk of postoperative complications. The aim of this open, randomized controlled trial was to examine the effect of supplementary per oral immunonutrition (IN) seven days before surgery for pancreatic cancer (PC) on postoperative complications and length of hospital stay (LOS). Secondary outcomes were the changes in functional capability and body weight (BW). Consecutive patients referred for surgery for diagnosed or plausible PC were included...
2016: Nutrition and Cancer
Maria C Mir, Laura Izquierdo
Assessment of nutritional status by an objective measure such as NRS-2002 or sarcopenia in the preoperative workup of major abdominal surgeries helps identify patients at risk for increased surgical morbidity and mortality. Preoperative and immediate postoperative nutritional supplements have demonstrated to decrease risk of complications and length of stay. Enhancing the immune system with immunonutrition has also been suggested as major player in this setting. In this review on nutritional considerations in the perioperative setting of radical cystectomy, we will describe several tools available to improve the complications rates and mortality surrounding this procedure...
April 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Pedro Moya, Elena Miranda, Leticia Soriano-Irigaray, Antonio Arroyo, Maria-Del-Mar Aguilar, Marta Bellón, Jose-Luis Muñoz, Fernando Candela, Rafael Calpena
OBJECTIVE: To determine whether the joint implementation of immunonutrition and a laparoscopic approach improves morbidity, mortality, and length of stay (LOS) compared with dietary advice. BACKGROUND: Despite progress in recent years in the surgical management of patients with colorectal cancer, postoperative complications are frequent. Nutritional supplements enriched with immunonutrients have recently been introduced into clinical practice. However, the immunonutrition benefits in patients undergoing colorectal laparoscopic surgery are unknown...
March 2, 2016: Surgical Endoscopy
Jill M Hamilton-Reeves, Misty D Bechtel, Lauren K Hand, Amy Schleper, Thomas M Yankee, Prabhakar Chalise, Eugene K Lee, Moben Mirza, Hadley Wyre, Joshua Griffin, Jeffrey M Holzbeierlein
UNLABELLED: After radical cystectomy (RC), patients are at risk for complications including infections. The expansion of myeloid-derived suppressor cells (MDSCs) after surgery may contribute to the lower resistance to infection. Immune response and postoperative complications were compared in men consuming either specialized immunonutrition (SIM; n=14) or an oral nutrition supplement (ONS; n=15) before and after RC. MDSC count (Lin- CD11b+ CD33+) was significantly different between the groups over time (p=0...
March 2016: European Urology
Raquel Escortell Sánchez, Manuel Reig García-Galbis
OBJECTIVE: to identify what effect causes enteral nutrition on nutritional status of cancer. METHOD: a search was performed using the keywords "Cancer" AND "Enteral Nutrition" AND "Supplementation" in four document databases: Pubmed, EBSCO, ProQuest, and Web of Science. INCLUSION CRITERIA: age of the sample, major than 18 years; submitted to surgery for cancer; that the intervention program was including diet and employment or not of nutritional Supplementation; clinical trials published between January 2004 and December 2014, in scientific journals indexed...
2015: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Jaime Ruiz-Tovar, Lorea Zubiaga, Maria Diez, Ana Murcia, Evangelina Boix, José Luis Muñoz, Carolina Llavero
BACKGROUND: Between 2 and 8 weeks before surgery, most bariatric surgery groups establish strict dietary treatments with a total caloric intake of less than 1,000 kcal/day in order to maximize weight loss during this period of time. METHODS: A prospective randomized clinical trial of all the patients undergoing laparoscopic sleeve gastrectomy (LSG) was performed. Patients were randomly assigned into 3 groups: those patients receiving a preoperative regular diet of 900 kcal/day (group 1), those receiving a preoperative balanced energy high-protein formula (group 2) and those receiving preoperative Immunonutrition (group 3)...
June 2016: Obesity Surgery
D Goéré, A Sa Cunha
The surgeon plays a key role in the perioperative nutritional care in patients undergoing elective major digestive surgery; therefore, he has to be able to anticipate needs and to implement corrective measures according to recommendations. Pre- and postoperative enteral feeding is preferred. In patients without obvious undernutrition, postoperative nutritional support has to be initiated if patients cannot maintain oral intake above 60% of recommended intake for more than 7 days, and it has to be programmed if it is anticipated that the patient will be unable to eat for more than 7 days...
August 2015: Journal of Visceral Surgery
C Mariette
ERAS programs are based on a combination of perioperative measures with a proven efficacy, that combined with each other lead to an enhanced recovery after surgery through a synergistic pathway. Such programs help to decrease postoperative morbidity and to reduce length of hospital stay. Beside immunonutrition, carbohydrate loading until 2 hours before surgery and early postoperative oral feeding are safe and allows enhanced recovery after surgery.
August 2015: Journal of Visceral Surgery
C Mariette
Based on a grade A level of evidence, immunonutrition should be given to all patients operated on for a digestive cancer 5 to 7 days prior to surgery whatever could be the patient nutritional status. Immunonutrition should be continued in the postoperative phase in malnourished patients for 5 to 7 days or until patients are able to recover oral feeding covering at least 60% of their needs.
August 2015: Journal of Visceral Surgery
Guo-Min Song, Xu Tian, Hui Liang, Li-Juan Yi, Jian-Guo Zhou, Zi Zeng, Ting Shuai, Yang-Xiang Ou, Lei Zhang, Yan Wang
Gastric cancer (GC) is one of the most common upper gastrointestinal malignancies. Surgical resection remains the mainstay of curative treatment for GC. Enteral immunonutrition (EIN) has been increasingly used to enhance host immunity and relieve inflammatory response of patients undergoing surgery for GC; however, conclusions across studies still remain unclear. We aimed to evaluate the effects of EIN for such patients.We searched some electronic databases including PubMed, EBSCO-Medline, Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE to identify any latent studies which investigated the effects of EIN compared with standard EN on GC patients who undergoing surgery until the end of December 30, 2014...
August 2015: Medicine (Baltimore)
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