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根治性胰十二指肠切除术患者的术前免疫营养与术后结局

Preoperative Immunonutrition and Postoperative Outcomes in Radical Pancreaticoduodenectomy Patients.

作者信息

Aba Murat, Sarıtaş Ahmet Gökhan, Yavuz Burak, Dalcı Kubilay, Ülkü Abdullah, Akçam Atılgan Tolga

机构信息

Department of General Surgery, Diyarbakır Selahattin Eyyubi Devlet Hastanesi, Diyarbakır, Turkey.

Department of General Surgery, Çukurova University Faculty of Medicine, Adana, Turkey.

出版信息

Turk J Gastroenterol. 2023 Nov 21;35(1):32-40. doi: 10.5152/tjg.2023.22793.

DOI:10.5152/tjg.2023.22793
PMID:37987583
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10837524/
Abstract

BACKGROUND/AIMS: This study aimed to compare the patient groups who received and did not receive immunonutrition in terms of mortality and morbidity in patients who underwent radical pancreaticoduodenectomy.

MATERIALS AND METHODS

Two groups were formed from 40 patients who underwent radical pancreaticoduodenectomy in our clinic in 2021. The patients in study group were given enteral immunonutrition support for 5 days preoperatively. For this purpose, a standard enteral immunonutrition product containing arginine, omega-3 fatty acids, and RNA (dietary nucleotides) was used. Patients' data of demographical, laboratory, postoperative complications, and current clinical status were analyzed.

RESULT

Mortality developed in 5 (25 %) patients in the treatment group and 4 (20 %) patients in the control group in the following months (P > .05). The estimated survival rate in the treatment group was 21.8 ± 2.8 months in the treatment group 19.1 ± 1.7 months in the control group (P > .05). The length of hospital stay was 12.89 ± 3.3 days in the treatment group, while it was 16.47 ± 6.83 days in the control group (P < .05). In the postoperative follow-ups, delayed gastric emptying symptoms developed in 3 patients in the treatment group, while the same complication was observed in 9 patients in the control group (P < .05). Surgical site infections occurred in 4 patients in the treatment group and 9 patients in the control group (P < .05).

CONCLUSION

It was observed that preoperative oral immunonutrition before pancreaticoduodenectomy was effective in reducing the risk of delayed gastric emptying after surgery and the length of hospital stay.

摘要

背景/目的：本研究旨在比较接受和未接受免疫营养的患者在接受根治性胰十二指肠切除术后的死亡率和发病率。

材料与方法

选取2021年在我院接受根治性胰十二指肠切除术的40例患者，分为两组。研究组患者在术前5天给予肠内免疫营养支持。为此，使用了一种含有精氨酸、ω-3脂肪酸和RNA（膳食核苷酸）的标准肠内免疫营养产品。分析患者的人口统计学、实验室检查、术后并发症及当前临床状况数据。

结果

治疗组5例（25%）患者和对照组4例（20%）患者在接下来的几个月内出现死亡（P>.05）。治疗组的估计生存率为21.8±2.8个月，对照组为19.1±1.7个月（P>.05）。治疗组的住院时间为12.89±3.3天，而对照组为16.47±6.83天（P<.05）。在术后随访中，治疗组3例患者出现胃排空延迟症状，而对照组9例患者出现相同并发症（P<.05）。治疗组4例患者发生手术部位感染，对照组9例患者发生手术部位感染（P<.05）。

结论

观察到胰十二指肠切除术前口服免疫营养可有效降低术后胃排空延迟的风险和缩短住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/6f54addf27bf/tjg-35-1-32_f007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/e2bb783a5a23/tjg-35-1-32_f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/7e7b4fccc010/tjg-35-1-32_f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/60848266173e/tjg-35-1-32_f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/d495f6491b59/tjg-35-1-32_f004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/cd03ccf053be/tjg-35-1-32_f005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/9123571b7e96/tjg-35-1-32_f006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/6f54addf27bf/tjg-35-1-32_f007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/e2bb783a5a23/tjg-35-1-32_f001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/7e7b4fccc010/tjg-35-1-32_f002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/60848266173e/tjg-35-1-32_f003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/d495f6491b59/tjg-35-1-32_f004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/cd03ccf053be/tjg-35-1-32_f005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/9123571b7e96/tjg-35-1-32_f006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e178/10837524/6f54addf27bf/tjg-35-1-32_f007.jpg

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[Surgery for periampullary pancreatic cancer].[壶腹周围胰腺癌的手术治疗]
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