Perioperative enteral immunonutrition modulates systemic and mucosal immunity and the inflammatory response in patients with periampullary cancer scheduled for pancreaticoduodenectomy: A randomized clinical trial
Hamza N.,NorthManchester General Hospital |
Hamza N.,Royal Infirmary |
Hamza N.,University of Manchester |
Darwish A.,Royal Infirmary |
And 10 more authors.
Results: The groups were comparable for demographics, the concentrations of mediators of systemic and mucosal immunity at time of recruitment, and for the duration and amount of feed received. Preoperative EIN rather than SEN was associated with significant reductions in plasma tumor necrosis factor α and total hemolytic complement. Enteral immunonutrition-fed patients had significantly higher total lymphocyte count on the third postoperative day and significantly greater rise in CD4/CD8 ratio from day 3 to day 7 postoperatively compared with SENfed patients.Methods: Thirty-seven patients were randomized (EIN, n = 17; SEN, n = 20) to receive feed for 14 days preoperatively and 7 days postoperatively. Mediators of systemic immunity (interleukin 1α, tumor necrosis factor α, lymphocytes subsets, and complement components) and of mucosal immunity in duodenal biopsies, nutritional markers and parameters were evaluated.Conclusions: The perioperative administration of EINrather than SENis associated with a favorable modulation of the inflammatory response and enhancement of systemic immunity in patients undergoing pancreaticoduodenectomy for periampullary cancer.Objectives: Nutritional deficiencies and immune dysfunction in cancer patients may contribute to postoperative septic morbidity. This trial compared the effects of perioperative enteral immunonutrition (EIN) versus standard enteral nutrition (SEN) on systemic and mucosal immunity in patients undergoing pancreaticoduodenectomy for periampullary cancer. © 2014 Lippincott Williams & Wilkins. Source