Martínez González Ángel, Llópiz Castedo José, Rodeiro Escobar Pedro, González Nunes Manuella, Fernández López Bárbara, García Cardoner María de Los Ángeles, Fraile Amador Francisco Javier, Rodriguez Zorrilla Samuel, Martínez González María Inmaculada, Rodeiro Marta Santiago Enrique
Servicio de Endocrinología y Nutrición. Complejo Hospitalario Universitario de Pontevedra.
Medicina Familiar y Comunitaria. Área Sanitaria de Vigo.
Nutr Hosp. 2024 Apr 26;41(2):330-337. doi: 10.20960/nh.04934.
Objective: to assess the effectiveness of immunonutrition (IN) compared to standard nutritional formulas in patients undergoing gastric cancer surgery. Material and methods: this is a real-life, observational retrospective cohort study. It included 134 patients, all of whom underwent gastrectomy at Montecelo Hospital between December 2019 and December 2022. Group A (N = 79 patients) received standard nutrition, and Group B (N = 55 patients) received formulas containing arginine, nucleotides, omega-3 fatty acids, and extra virgin olive oil. This protocol was carried out both pre and postoperatively for an average period of 10 days. The study evaluated hospital stay, the need for parenteral nutrition (PN), postoperative complications, as well as anthropometric and laboratory variables. Statistical analyses were performed using Stata 16.1.® Results: in the IN group compared to the standard nutrition group, the hospital stay was reduced by 34 % (p < 0.001). The number of patients requiring PN decreased by 21.1 % (p = 0.022), and its duration also decreased by 33.2 % (p < 0.001). The risk of infectious complications was lower with IN, specifically 70.1 % less (p < 0.001). As for other postoperative complications, IN reduced the risk of intestinal obstruction by 84 % (p < 0.002), suture dehiscence by 90.9 % (p < 0.001), blood transfusion by 99.8 % (p < 0.001), pleural effusion by 90.9 % (p = 0.021), acute renal failure by 84.02 % (p = 0.047), and surgical re-intervention by 69.93 % (p < 0.011). In the IN group, there was less weight loss (p = 0.048) and a smaller decrease in postoperative albumin (p = 0.005) and cholesterol (p < 0.001). Conclusion: immunonutrition reduces postoperative complications, decreases hospital stay, and optimizes nutritional outcomes.
评估免疫营养（IN）与标准营养配方相比，对接受胃癌手术患者的有效性。材料与方法：这是一项基于现实生活的观察性回顾性队列研究。研究纳入了134例患者，所有患者均于2019年12月至2022年12月期间在蒙特切洛医院接受了胃切除术。A组（n = 79例患者）接受标准营养，B组（n = 55例患者）接受含有精氨酸、核苷酸、ω-3脂肪酸和特级初榨橄榄油的配方。该方案在术前和术后均实施，平均为期10天。研究评估了住院时间、肠外营养（PN）需求、术后并发症以及人体测量和实验室指标。使用Stata 16.1®进行统计分析。结果：与标准营养组相比，IN组的住院时间缩短了34%（p < 0.001）。需要PN的患者数量减少了21.1%（p = 0.022），PN持续时间也减少了33.2%（p < 0.001）。IN组感染并发症的风险较低，具体降低了70.1%（p < 0.001）。至于其他术后并发症，IN降低了肠梗阻风险84%（p < 0.002）、缝合口裂开风险90.9%（p < 0.001）、输血风险99.8%（p < 0.001）、胸腔积液风险90.9%（p = 0.021）、急性肾衰竭风险84.02%（p = 0.047）以及手术再次干预风险69.93%（p < 0.011）。在IN组中，体重减轻较少（p = 0.048），术后白蛋白（p = 0.005）和胆固醇（p < 0.001）下降幅度较小。结论：免疫营养可减少术后并发症，缩短住院时间，并优化营养结局。
