Huang Yong, Yin Chunmei, Wang Jue, Wang Maijian, Zheng Xingbin, Xie Ming, Wang Jiwei
Department of General Surgery, Digestive Disease Hospital, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People's Republic of China.
Cancer Manag Res. 2024 Oct 2;16:1329-1344. doi: 10.2147/CMAR.S476648. eCollection 2024.
This study investigated the effects of parenteral glutamine (Gln) supplement immunonutrition versus conventional nutritional support on postoperative Clavien-Dindo classification complications and recovery, perioperative nutritional status, and immune, inflammation, and safety indicators in patients with colorectal cancer (CRC).
Clinical data were collected for a retrospective cohort study of 178 patients (58 and 120 patients in the observation and control groups, respectively) who underwent radical resection of CRC from January 2019 to December 2021. The incidence of postoperative complications was calculated. Postoperative recovery, nutritional indicators, inflammatory factors indicator, and the safety indicators before operation and at 1, 3, and 7 days after operation were compared. SPSS 29.0 statistical software was used for statistical analysis.
The incidence of postoperative overall complications in the control group and the observation group was 22.50% (27/120) and 17.24% (10/58), respectively, and there was no significant difference between the two groups (=0.42). The incidence of postoperative complications of Clavien-Dindo grade ≥III in the control group and the observation group was 14.17% (17/120) and 3.45% (2/58), respectively, and the difference between the two groups was statistically significant (=0.03). Secondary outcomes (first exhaust, defecation, and liquid diet intake times) were significantly recovered earlier in the observation group than those in the control group (<0.05), while the postoperative hospital stay was significantly shorter(=0.04). The perioperative nutritional status did not significantly differ between the groups before and after surgery(>0.05), although significant differences were observed in several inflammatory and safety indicators(<0.05).
Unlike conventional nutritional support, postoperative parenteral Gln supplementation reduced the incidence of postoperative Clavien-Dindo complications grade ≥III in patients with CRC while increasing intestinal and immune functions, decreasing inflammation, and reducing the length of hospital stay.
本研究探讨肠外谷氨酰胺（Gln）补充免疫营养与传统营养支持对结直肠癌（CRC）患者术后Clavien-Dindo分类并发症及恢复情况、围手术期营养状况以及免疫、炎症和安全指标的影响。
收集2019年1月至2021年12月期间接受CRC根治性切除术的178例患者（观察组58例，对照组120例）的临床资料进行回顾性队列研究。计算术后并发症发生率。比较术后恢复情况、营养指标、炎症因子指标以及术前和术后1天、3天、7天的安全指标。采用SPSS 29.0统计软件进行统计分析。
对照组和观察组术后总体并发症发生率分别为22.50%（27/120）和17.24%（10/58），两组间差异无统计学意义（=0.42）。对照组和观察组Clavien-Dindo≥III级术后并发症发生率分别为14.17%（17/120）和3.45%（2/58），两组间差异有统计学意义（=0.03）。次要结局（首次排气、排便及流食摄入时间）观察组较对照组明显恢复更早（<0.05），而术后住院时间明显更短（=0.04）。两组围手术期营养状况在术前和术后差异无统计学意义（>0.05），但在多项炎症和安全指标上存在显著差异（<0.05）。
与传统营养支持不同，术后肠外补充Gln可降低CRC患者术后Clavien-Dindo≥III级并发症的发生率，同时增强肠道和免疫功能，减轻炎症反应，并缩短住院时间。
