|Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients|
|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|
|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|
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.
|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
|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.|
|APA||Liang, Bin.,Wang, Shan.,Ye, Ying-Liang.,Yang, Xiao-Dong.,Wang, You-Li.,...&Yin, Mu-Jun.(2008).Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients.WORLD JOURNAL OF GASTROENTEROLOGY,14(15),2434-2439.|
|MLA||Liang, Bin,et al."Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients".WORLD JOURNAL OF GASTROENTEROLOGY 14.15(2008):2434-2439.|