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结直肠癌手术中寡肽高蛋白质等热量术后饮食与免疫营养素补充剂的比较:一项多中心、双盲、随机临床试验结果。

Postoperative Diet with an Oligomeric Hyperproteic Normocaloric Supplement versus a Supplement with Immunonutrients in Colorectal Cancer Surgery: Results of a Multicenter, Double-Blind, Randomized Clinical Trial.

机构信息

Coloproctology Unit, Department of Surgery, Reina Sofia University Hospital, 30003 Murcia, Spain.

Department of Surgery, University Hospital of Fuenlabrada, 28942 Madrid, Spain.

出版信息

Nutrients. 2022 Jul 26;14(15):3062. doi: 10.3390/nu14153062.

DOI:10.3390/nu14153062
PMID:35893914
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9331223/
Abstract

(1) Background: For normo-nourished colorectal cancer patients, the need for immunonutrients after elective surgery is not known. (2) Methods: Multicenter, randomized, double-blind, phase III clinical trial comparing the postoperative diet with 200 mL oligomeric hyperproteic normocaloric (OHN; experimental arm) supplement vs. 200 mL immunonutritional (IN) (active comparator) supplement twice a day for five days in 151 normo-nourished adult colorectal-resection patients following the multimodal rehabilitation ERAS protocol. The proportions of patients with complications (primary outcome) and those who were readmitted, hospitalized for <7 days, had surgical site infections, or died due to surgical complications (secondary outcome) were compared between the two groups until postoperative day 30. Tolerance to both types of supplement and blood parameters was also assessed until day 5. (3) Results: Mean age was 69.2 and 84 (58.7%) were men. Complications were reported in 41 (28.7%) patients and the incidence did not differ between groups (18 (25%) vs. 23 (32.4%) patients with OHN and IN supplement, respectively; p = 0.328). No significant differences were found for the rest of the variables. (4) Conclusions: IN supplement may not be necessary for the postoperative recovery of colorectal cancer patients under the ERAS regimen and with normal nutritional status at the time of surgery.

摘要

(1) 背景:对于营养状况正常的结直肠癌患者,择期手术后是否需要免疫营养素尚不清楚。(2) 方法:这是一项多中心、随机、双盲、III 期临床试验,比较了术后饮食与每天两次口服 200 毫升低聚高蛋白能量正常(OHN;实验组)补充剂与 200 毫升免疫营养(IN)(阳性对照)补充剂在 151 例接受多模式康复 ERAS 方案的营养状况正常的成年结直肠切除患者中的作用。比较两组患者的并发症(主要结局)和再入院、住院<7 天、手术部位感染或因手术并发症死亡的患者比例(次要结局),直至术后第 30 天。还评估了两组患者对两种补充剂的耐受性和血液参数,直至第 5 天。(3) 结果:患者的平均年龄为 69.2 岁,84 例(58.7%)为男性。有 41 例(28.7%)患者报告有并发症,两组的发生率无差异(OHN 组和 IN 组分别有 18 例[25%]和 23 例[32.4%]患者发生并发症;p = 0.328)。其余变量无显著差异。(4) 结论:对于接受 ERAS 方案治疗且手术时营养状况正常的结直肠癌患者,术后恢复期间可能不需要补充 IN。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f36f/9331223/a904e863305b/nutrients-14-03062-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f36f/9331223/a904e863305b/nutrients-14-03062-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f36f/9331223/a904e863305b/nutrients-14-03062-g001.jpg

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Clinical and Nutritional Effectiveness of a Nutritional Protocol with Oligomeric Enteral Nutrition in Patients with Oncology Treatment-Related Diarrhea.
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The role of dietary prehabilitation on anastomotic healing.饮食康复在吻合口愈合中的作用。
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