Details

Autor(en) / Beteiligte

• Liang, Bin
• Wang, Shan
• Ye, Ying-Jiang
• Yang, Xiao-Dong
• Wang, You-Li
• Qu, Jun
• Xie, Qi-Wei
• Yin, Mu-Jun

Titel

Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients

Ist Teil von

• World journal of gastroenterology : WJG, 2008-04, Vol.14 (15), p.2434-2439

Ort / Verlag

United States: Division of Surgical Oncology and Division of Gastroenteroiogieal Surgery, Peking University People's Hospital, Beijing 100044, China

Erscheinungsjahr

2008

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• AIM： To investigate the effect of omega-3 fatty acid parenteral supplementation postoperatively on clinical outcomes and immunomodulation in colorectal cancer patients. METHODS： Forty-two patients undergoing radical colorectal cancer resection with an indication for total parenteral nutrition postoperatively were enrolled in this prospective, double-blind, randomized, controlled study. Patients received total parenteral nutrition supplemented with either soybean oil （LCT; Intralipid, Fresenius-Kabi, SO group, n = 21） or a combination of omega-3 fish oil and soybean oil （LCT：fish oil = 5：1, fish oil; Omegaven, Fresenius-Kabi, FO group, n = 21）, up to a total of 1.2 g lipid/kg per day for 7 d postoperatively. A same volume calorie and nitrogen was administrated. Routine blood test, biochemistry, systemic levels of IL-6 and TNF-α, percentage of CD3＋, CD4＋, and CD8＋ lymphocytes were evaluated preoperatively and on postoperative d 1 and 8. Patient outcome was evaluated considering mortality during the hospital stay, length of postoperative hospital stay, and occurrence of infectious complications. RESULTS： Both lipid regimens were well tolerated. No differences between the two groups were noticed in demographics, baseline blood test, biochemistry, serum levels of IL-6 and TNF-α, percentage of CD4＋, CD8＋ lymphocytes, and ratios of CD4＋/CD8＋. Compared with those on postoperative d 1, serum IL-6 levels onpostoperative d 8 were significantly depressed in the FO group than in the reference group （-44.43 ± 30.53 vs -8.39 ± 69.08, P = 0.039）. Simultaneously, the ratios of CD4＋/CD8＋ were significantly increased in the FO group （0.92 ± 0.62 vs 0.25 ± 1.22, P = 0.035）. In addition, depression of serum TNF-α levels （-0.82 ± 2.71 vs 0.27 ± 1.67, P = 0.125） and elevation of CD3＋ and CD4＋ lymphocyte percentage （12.85 ± 11.61 vs 3.84 ± 19.62, P = 0.081, 17.80 ± 10.86 vs 9.66 ± 17.55, P = 0.084, respectively） were higher in the FO group than in the reference group. Patients in the FO group trended to need a shorter postoperative hospital stay （17.45 ± 4.80 d vs 19.62 ± 5.59 d, P = 0.19）. No statistically significant difference was found when stratified to mortality and occurrence of infectious complications. CONCLUSION： Postoperative supplementation of omega-3 fatty acids may have a favorable effect on the outcomes in colorectal cancer patients undergoing radical resection by lowering the magnitude of inflammatory responses and modulating the immune response.