Okabayashi Takehiro, Nishimori Isao, Sugimoto Takeki, Maeda Hiromichi, Dabanaka Ken, Onishi Saburo, Kobayashi Michiya, Hanazaki Kazuhiro
Department of Surgery, Kochi Medical School, Kochi, Japan.
J Gastroenterol Hepatol. 2008 Dec;23(12):1869-73. doi: 10.1111/j.1440-1746.2008.05504.x. Epub 2008 Aug 20.
Most patients with hepatocellular carcinoma (HCC) have underlying liver cirrhosis that is frequently associated with a state of protein energy malnutrition. The aim of this study was to evaluate the clinical benefit of perioperative supplementation of a branched-chain amino acid-enriched nutrient-mixture for patients undergoing liver resection for HCC.
A total of 112 patients with HCC who underwent hepatic resection were enrolled in this study. These patients were divided into two groups: 40 patients received perioperative supplementation of branched-chain amino acid-enriched nutrient-mixture (AEN group) and 72 patients did not (control group). Laboratory data, postoperative complications, duration of hospitalization, and survival were assessed for each group and compared.
The overall incidence of postoperative complications was lower in the AEN group (17.5%) than in the control group (44.4%) (P = 0.01). Among the postoperative complications, surgical site infection and bile leakage was observed in 5% of patients in the AEN group and in 15.3% and 12.5% of patients in the control group, respectively. Ascites appeared after the surgery in 7.5% of patients in the AEN group and in 16.7% of patients in the control group. The duration of hospitalization was significantly shorter in the AEN group was than in the control group (P < 0.05).
This study strongly suggests that perioperative supplementation of a branched-chain amino acid-enriched nutrient-mixture is clinically beneficial in reducing the morbidity associated with postoperative complications and in shortening the duration of hospitalization of patients with chronic liver disease who undergo liver resection for HCC.
大多数肝细胞癌(HCC)患者存在潜在的肝硬化,这常与蛋白质能量营养不良状态相关。本研究的目的是评估围手术期补充富含支链氨基酸的营养混合物对接受肝癌肝切除术患者的临床益处。
本研究共纳入112例接受肝切除的HCC患者。这些患者被分为两组:40例患者围手术期补充富含支链氨基酸的营养混合物(AEN组),72例患者未补充(对照组)。对每组的实验室数据、术后并发症、住院时间和生存率进行评估并比较。
AEN组术后并发症的总体发生率(17.5%)低于对照组(44.4%)(P = 0.01)。在术后并发症中,AEN组5%的患者出现手术部位感染和胆漏,而对照组分别为15.3%和12.5%。AEN组7.5%的患者术后出现腹水,对照组为16.7%。AEN组的住院时间明显短于对照组(P < 0.05)。
本研究强烈表明,围手术期补充富含支链氨基酸的营养混合物在临床上有利于降低接受肝癌肝切除术的慢性肝病患者术后并发症的发病率,并缩短其住院时间。