Moya Pedro, Miranda Elena, Soriano-Irigaray Leticia, Arroyo Antonio, Aguilar Maria-Del-Mar, Bellón Marta, Muñoz Jose-Luis, Candela Fernando, Calpena Rafael
Department of Surgery and Pathology, University Miguel Hernandez of Elche, Elche, Spain.
Division of Colorectal Surgery, Department of General Surgery, University General Hospital of Elche, Elche, Spain.
Surg Endosc. 2016 Nov;30(11):4946-4953. doi: 10.1007/s00464-016-4836-7. Epub 2016 Mar 2.
To determine whether the joint implementation of immunonutrition and a laparoscopic approach improves morbidity, mortality, and length of stay (LOS) compared with dietary advice.
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.
This study was a prospective, randomized trial with two parallel treatment groups receiving an immune-enhancing dietary supplement for 7 days before colorectal resection and 5 days postoperatively or dietary advice.
A total of 128 patients were randomized. At baseline, both groups were comparable with respect to age, sex, surgical risk, comorbidities, and analytical and nutritional parameters. The median postoperative LOS was 5 days and was not significantly different between the groups. Wound infection differed significantly between the groups (11.50 vs. 0.00 %, p = 0.006). No other differences between the groups were identified.
The joint use of laparoscopy and supplementation with immunonutrients reduces surgical wound infection in patients undergoing colorectal surgery.
This study is registered with ClinicalTrial.gov : NCT0239396.
确定与饮食建议相比，免疫营养与腹腔镜手术联合应用是否能改善发病率、死亡率和住院时间（LOS）。
尽管近年来结直肠癌患者的外科治疗取得了进展，但术后并发症仍很常见。富含免疫营养成分的营养补充剂最近已引入临床实践。然而，免疫营养对接受结直肠腹腔镜手术患者的益处尚不清楚。
本研究是一项前瞻性随机试验，两个平行治疗组在结直肠切除术前7天和术后5天接受免疫增强型膳食补充剂或饮食建议。
共有128例患者被随机分组。在基线时，两组在年龄、性别、手术风险、合并症以及分析和营养参数方面具有可比性。术后中位住院时间为5天，两组之间无显著差异。两组伤口感染情况差异显著（11.50% 对0.00%，p = 0.006）。未发现两组之间的其他差异。
腹腔镜手术与免疫营养补充剂联合使用可降低结直肠手术患者的手术伤口感染率。
本研究已在ClinicalTrial.gov注册：NCT0239396 。
