Kitagawa Hiroyuki, Namikawa Tsutomu, Yatabe Tomoaki, Munekage Masaya, Yamasaki Fumiyasu, Kobayashi Michiya, Hanazaki Kazuhiro
Department of Surgery, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan.
Department of Anesthesiology, Kochi Medical School, Kohasu-Okocho, Nankoku, Kochi, 783-8505, Japan.
Langenbecks Arch Surg. 2017 May;402(3):531-538. doi: 10.1007/s00423-016-1538-5. Epub 2017 Mar 10.
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.
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.
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.
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.
本初步研究旨在调查术前免疫调节饮食（IMD）对食管癌患者行胸腔镜食管切除术后的影响。
30例被诊断为可切除食管癌的患者被分为两组：IMD组（n = 15）和标准流食组（SLD；n = 15）。我们将术后参数，如并发症发生率和细胞因子术后水平作为主要终点进行评估。次要终点是住院时间。
IMD组和SLD组中，白细胞介素（IL）-6和肿瘤坏死因子（TNF）-α的峰值水平分别出现在术后第1天（POD 1）和术后第2天（POD 2）。两组中C反应蛋白（CRP）的峰值水平均出现在POD 3（IMD组为9.9mg/dL，SLD组为15.2mg/dL）。总体而言，IMD组中的TNF-α水平低于SLD组（P = 0.033）。此外，IMD组中的IL-6（P = 0.182）和CRP（P = 0.191）水平以及术后肺炎的发生率（7.1%对26.7%；P = 0.330）均有低于SLD组的趋势。
术前IMD可抑制食管癌患者胸腔镜食管切除术后TNF-α水平的升高，尽管在IL-6、CRP或术后并发症方面未检测到不同趋势。
