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学科主题: 临床医学
题名:
Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients
作者: Liang, Bin1,2; Wang, Shan1,2; Ye, Ying-Liang1,2; Yang, Xiao-Dong1,2; Wang, You-Li1,2; Qu, Jun1,2; Xie, Qi-Wei1,2; Yin, Mu-Jun1,2
关键词: colorectal cancer ; parenteral nutrition ; omega-3 fatty acids ; immunomodulation ; abdominal surgery
刊名: WORLD JOURNAL OF GASTROENTEROLOGY
发表日期: 2008-04-21
DOI: 10.3748/wjg.14.2434
卷: 14, 期:15, 页:2434-2439
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Gastroenterology & Hepatology
研究领域[WOS]: Gastroenterology & Hepatology
关键词[WOS]: MAJOR ABDOMINAL-SURGERY ; SPLANCHNIC BLOOD-FLOW ; FISH-OIL ; OMEGA-3-FATTY-ACIDS IMPROVE ; LEUKOTRIENE SYNTHESIS ; LIPID EMULSIONS ; CRITICALLY-ILL ; RAT MODEL ; GENERATION ; SEPSIS
英文摘要:

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 (R), 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 (R), 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-alpha, 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-alpha, percentage of CD4+, CD8(+) lymphocytes, and ratios of CD4(+)/CD8(+). Compared with those on postoperative d 1, serum IL-6 levels on postoperative 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-alpha 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, (c) 2008 WJG. All rights reserved.

语种: 英语
WOS记录号: WOS:000255252700024
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/59843
Appears in Collections:北京大学第二临床医学院_期刊论文

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作者单位: 1.Peking Univ, Div Gastroenterol Surg, Peoples Hosp, Beijing 100044, Peoples R China
2.Peking Univ, Div Surg Oncol, Peoples Hosp, Beijing 100044, Peoples R China

Recommended Citation:
Liang, Bin,Wang, Shan,Ye, Ying-Liang,et al. Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients[J]. WORLD JOURNAL OF GASTROENTEROLOGY,2008,14(15):2434-2439.
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