BACKGROUND& AIMS: Perioperative nutrition with specialized enteral diets improves outcome when compared with standard formulas. A post-hoc analysis suggested preoperative administration as the most important period. Thus, we designed a study to understand prospectively whether preoperative supplementation could be as efficacious as the perioperative approach and superior to a conventional treatment (no artificial nutrition) in reducing postoperative infections and length of hospital stay. METHODS: A total of 305 patients with preoperative weight loss <10% and cancer of the gastrointestinal tract were randomized to receive the following: (1) oral supplementation for 5 days before surgery with 1 L/day of a formula enriched with arginine, omega-3 fatty acids, and RNA, with no nutritional support given after surgery (preoperative group, n = 102); (2) the same preoperative treatment plus postoperative jejunal infusion with the same enriched formula (perioperative group, n = 101); and (3) no artificial nutrition before and after surgery (conventional group; n = 102). RESULTS: The 3 groups were comparable for all baseline and surgical characteristics. Intention-to-treat analysis showed a 13.7% incidence of postoperative infections in the preoperative group, 15.8% in the perioperative group, and 30.4% in the conventional group (P = 0.006 vs. preoperative; P = 0.02 vs. perioperative). Length of hospital stay was 11.6 +/- 4.7 days in the preoperative group, 12.2 +/- 4.1 days in the perioperative group, and 14.0 +/- 7.7 days in the conventional group (P = 0.008 vs. preoperative and P = 0.03 vs. perioperative). CONCLUSIONS: Preoperative supplementation is as effective as perioperative administration in improving outcome. Both strategies seem superior to the conventional approach

Gianotti, L., Braga, M., Nespoli, L., Radaelli, G., Beneduce, A., Di Carlo, V. (2002). A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. GASTROENTEROLOGY, 122(7), 1763-1770 [10.1053/gast.2002.33587].

A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer

GIANOTTI, LUCA VITTORIO;Braga, M;NESPOLI, LUCA CARLO;
2002

Abstract

BACKGROUND& AIMS: Perioperative nutrition with specialized enteral diets improves outcome when compared with standard formulas. A post-hoc analysis suggested preoperative administration as the most important period. Thus, we designed a study to understand prospectively whether preoperative supplementation could be as efficacious as the perioperative approach and superior to a conventional treatment (no artificial nutrition) in reducing postoperative infections and length of hospital stay. METHODS: A total of 305 patients with preoperative weight loss <10% and cancer of the gastrointestinal tract were randomized to receive the following: (1) oral supplementation for 5 days before surgery with 1 L/day of a formula enriched with arginine, omega-3 fatty acids, and RNA, with no nutritional support given after surgery (preoperative group, n = 102); (2) the same preoperative treatment plus postoperative jejunal infusion with the same enriched formula (perioperative group, n = 101); and (3) no artificial nutrition before and after surgery (conventional group; n = 102). RESULTS: The 3 groups were comparable for all baseline and surgical characteristics. Intention-to-treat analysis showed a 13.7% incidence of postoperative infections in the preoperative group, 15.8% in the perioperative group, and 30.4% in the conventional group (P = 0.006 vs. preoperative; P = 0.02 vs. perioperative). Length of hospital stay was 11.6 +/- 4.7 days in the preoperative group, 12.2 +/- 4.1 days in the perioperative group, and 14.0 +/- 7.7 days in the conventional group (P = 0.008 vs. preoperative and P = 0.03 vs. perioperative). CONCLUSIONS: Preoperative supplementation is as effective as perioperative administration in improving outcome. Both strategies seem superior to the conventional approach
Articolo in rivista - Articolo scientifico
Food, Formulated; Male; Gastrointestinal Neoplasms; Middle Aged; Female; Preoperative Care; Postoperative Care; Length of Stay; Incidence; Aged; Surgical Wound Infection; Humans
English
giu-2002
122
7
1763
1770
none
Gianotti, L., Braga, M., Nespoli, L., Radaelli, G., Beneduce, A., Di Carlo, V. (2002). A randomized controlled trial of preoperative oral supplementation with a specialized diet in patients with gastrointestinal cancer. GASTROENTEROLOGY, 122(7), 1763-1770 [10.1053/gast.2002.33587].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/16108
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