Hertlein Linda, Zeder-Göß Christine, Fürst Sophie, Bayer Daniela, Trillsch Fabian, Czogalla Bastian, Mahner Sven, Burges Alexander, Rittler Peter
Department of Obstetrics and Gynecology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Surgical Department, University Hospital, LMU Munich, Munich, Germany.
Arch Gynecol Obstet. 2018 Jun;297(6):1533-1538. doi: 10.1007/s00404-018-4759-8. Epub 2018 Apr 5.
Aim of this study was to determine whether peri-operative immunonutrition can decrease complications and the length of stay (LOS) in malnourished ovarian cancer patients.
Patients suspicious for advanced ovarian cancer before histopathological diagnosis and a nutritional risk score (NRS) ≥ 3 received oral immune-modulating diets (IMDs) for 5 days pre-operative and at least 5 days post-operative. Parameters for clinical outcome were infectious and non-infectious complications during hospital stay, and time of hospitalization. The results were compared with malnourished ovarian cancer patients of a previous study without any additive nutritional support (standard clinical diet/nutrition).
The infectious and non-infectious complication rate in the interventional group (IG) N = 28 was 42.9%, similar to the control group (CG) N = 19 with 42.1%, whereas the rate of infectious complications in the IG (21.4%) was slightly lower compared to the CG (26.3%). The median LOS of the IG was 18 days, and therefore, longer than LOS of the CG (15 days). Regarding the patients' compliance pre-operative 78.6% of the patients took the IMDs in an optimal and sufficient amount. Whereas after surgery, only eight (28.6%) patients were able to take IMDs in optimal and sufficient amount.
The current study showed no improvement of the complication rate or the time of hospitalization due to additional peri-operative immunonutrition in malnourished ovarian cancer patients. However, a trend towards the reduction of infectious complications could be seen in the IG.
本研究旨在确定围手术期免疫营养能否降低营养不良的卵巢癌患者的并发症发生率及住院时间。
在组织病理学诊断前怀疑为晚期卵巢癌且营养风险评分（NRS）≥3的患者，在术前5天及术后至少5天接受口服免疫调节饮食（IMD）。临床结局参数包括住院期间的感染性和非感染性并发症以及住院时间。将结果与先前一项未给予任何额外营养支持（标准临床饮食/营养）的营养不良卵巢癌患者研究进行比较。
干预组（IG，N = 28）的感染性和非感染性并发症发生率为42.9%，与对照组（CG，N = 19）的42.1%相似，而IG组的感染性并发症发生率（21.4%）略低于CG组（26.3%）。IG组的中位住院时间为18天，因此长于CG组（15天）。关于患者术前的依从性，78.6%的患者以最佳且充足的量服用了IMD。而术后，只有8名（28.6%）患者能够以最佳且充足的量服用IMD。
当前研究表明，在营养不良的卵巢癌患者中，围手术期额外给予免疫营养并不能改善并发症发生率或住院时间。然而，在IG组中可观察到感染性并发症有减少的趋势。
