Peritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, Spain.
Department of Medicine, University Jaume I (UJI), 12004 Valencia, Spain.
Nutrients. 2021 Jun 23;13(7):2147. doi: 10.3390/nu13072147.
The effect of preoperative immunonutrition intake on postoperative major complications in patients following cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) was assessed. The accuracy of C-Reactive Protein (CRP) for detecting postoperative complications was also analyzed. Patients treated within a peritoneal carcinomatosis program in which a complete or optimal cytoreduction was achieved were retrospectively analyzed. They were divided into two groups based on whether preoperative immunonutrition (IMN) or not (non-IMN) were administered. Clinical and surgical variables and postoperative complications were gathered. Predictive values of major morbidity of CRP during the first 3 postoperative days (POD) were also evaluated. A total of 107 patients were included, 48 belonging to the IMN group and 59 to the non-IMN group. In multivariate analysis immunonutrition (OR 0.247; 95%CI 0.071-0.859; = 0.028), and the number of visceral resections (OR 1.947; 95%CI 1.086-3.488; = 0.025) emerged as independent factors associated with postoperative major morbidity. CRP values above 103 mg/L yielded a negative predictive value of 84%. Preoperative intake of immunonutrition was associated with a decrease of postoperative major morbidity and might be recommended to patients with peritoneal carcinomatosis following CRS. Measuring CRP levels during the 3 first postoperative days is useful to rule out major morbidity.
评估了术前免疫营养摄入对接受细胞减灭术（CRS）联合或不联合腹腔内热化疗（HIPEC）的患者术后主要并发症的影响。还分析了 C-反应蛋白（CRP）检测术后并发症的准确性。对在腹膜肿瘤病计划中接受治疗的患者进行回顾性分析，这些患者在计划中实现了完全或最佳的细胞减灭术。根据是否给予术前免疫营养（IMN）将他们分为两组。收集了临床和手术变量以及术后并发症。还评估了 CRP 在术后前 3 天（POD）期间预测主要发病率的预测值。共纳入 107 例患者，其中 48 例为 IMN 组，59 例为非 IMN 组。多变量分析显示，免疫营养（OR 0.247；95%CI 0.071-0.859；P = 0.028）和内脏切除术数量（OR 1.947；95%CI 1.086-3.488；P = 0.025）是与术后主要发病率相关的独立因素。CRP 值高于 103 mg/L 时，阴性预测值为 84%。术前摄入免疫营养与术后主要发病率降低有关，可能会推荐给接受 CRS 后的腹膜肿瘤病患者。在术后前 3 天测量 CRP 水平有助于排除主要发病率。
