Postsurgery enteral nutrition in head and neck cancer patients.

Abstract

OBJECTIVE:

Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using an arginine-enriched diet, could improve nutritional variables as well as clinical outcomes.

DESIGN:

Randomized clinical trial.

SETTING:

Tertiary care.

SUBJECTS:

A population of 47 patients with oral and laryngeal cancer were enrolled.

INTERVENTIONS:

At surgery patients were randomly allocated to two groups: (a) patients receiving an enteral diet supplemented with arginine and fiber (group I); (b) patients receiving an isocaloric, isonitrogenous enteral formula (group II).

RESULTS:

No significant intergroup differences in the trend of the three plasma proteins and lymphocytes were detected. Gastrointestinal tolerance (diarrhea) of both formulas was good (17.4% group I and 8.3% group II; NS). During the 3 months after hospital discharge five patients died; no differences were detected between groups (13% group I and 8.3% group II; NS). The incidences postoperative infection complications were similar (nine patients) in both groups (21.7% group I and 16.7% group II; NS). Fistula were less frequent in enriched nutrition group (0% group I and 20.8% group II; P<0.05); wound infection was more frequent in group II, but without statistical difference (4.3% group I and 12.5% group II; NS). The length of postoperative stay was 22.8+/-11.8 days in the enriched group and 31.2+/-19.1 days in the control group (P=0.07).

CONCLUSIONS:

In conclusion, enriched formula improves local wound complications in postoperative head and neck cancer patients. Our results suggest that these patients could benefit from an immunonutrient-enhanced enteral formula.

• Authors: D A de Luis, R Aller, O Izaola, L Cuellar, M C Terroba
• Journal: European journal of clinical nutrition (Eur J Clin Nutr) Vol. 56 Issue 11 Pg. 1126-9 (Nov 2002) ISSN: 0954-3007 [Print] England
• PMID: 12428179 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Dietary Fiber
• Arginine

Topics

• Arginine (administration & dosage, therapeutic use)
• Dietary Fiber (administration & dosage, therapeutic use)
• Enteral Nutrition
• Female
• Head and Neck Neoplasms (complications, immunology, surgery, therapy)
• Humans
• Length of Stay
• Male
• Middle Aged
• Mortality
• Nutrition Disorders (immunology, prevention & control)
• Nutritional Status
• Postoperative Care
• Postoperative Complications (epidemiology, prevention & control)
• Prospective Studies
• Surgical Wound Infection (epidemiology)
• Treatment Outcome