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[9002057.] رقم البحث : 9002057 - |
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Effect Of Preoperative Nutrition Modulation On Postoperative Complications And Short -Term Outcome In Major Abdominal Cancer Surgery : An Immunological View / |
| تخصص البحث : General |
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SECI Oncology Journal / / vol.6 - 2018 |
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ندي طلعت فرغلي محمد |
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روماني جرجس نعيم - مؤلف رئيسي |
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Preoperative immunonutrition, cancer patients , total parenteral nutrition |
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Background: There has been a positive correlation between malnutrition and increased risk of infections. Additionally , protein caloric malnutrition occurs in up to 90% of surgical oncology patients . Malnutrition along with surgical stress predisposes patients to significant postoperative complications and immune depressions. Therefore, strategies have been implemented to circumvent malnutrition such as avoiding preoperative fasting, re-establishing oral feeding as soon as possible and maintaining good glycemic and metabolic control. Objective: We hypothesised that perioperative use of various biochemical agents such as non-essential ( glutamine , arginine ) or sulfur-containing amino acids , omega -3-poly unsaturated fatty acids , nucleotides and antioxidants ( free radical scavengers ) , may alter the immune response and could improve postoperative outcome in gastrointestinal cancer patients undergoing surgeries. Patients & Methods: This study was done after obtaining approval of the local ethics committee of faculty of medicine, Assiut University This randomized double –blinded prospective study was conducted on thirty patients.The patients were divided into two groups : Group1: (n=15) patients received preoperative I.V solutions as a control group and also received total parenteral nutrition immediately postoperative for 5 day , group 2 : (n=15) patients received 5 days preoperative (SMOF lipid ) 500ml/day in a peripheral venous line and also recieved total parenteral nutrition immediately postoperative in a central venous line as group (1) for 5 days. The effect of immunonutrition on the two groups was evaluated according to the WBC level , and the incidence of postoperative complications ( surgical site infection , fistula , chest infection ) , and hospital length of stay . Results: There were non significancant difference between the study groups inWBC level in the prenutritional , preoperative , postoperative day 1 , but there were a significant difference in the post operative day 3 samples , and in the post operative day 5 samples . There were significant difference between the two groups in the incidence of surgical site infection , and hospital stay postoperative. There were non significant difference between the two groups in the incidence of the fistula and chest infection postoperative. Conclusion: Preoperative immunonutrition support is effective in reducing postoperative complications in cancer patients. It helps to lower the risk of postoperative infectious complications and hospital lengh of stay. |
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