Saraswathy Sivaprasadan, Anju Kochupurackal Paul, Sudhindran Surendran, Uma Devi Padma
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Saraswathy Sivaprasadan1, Anju Kochupurackal Paul2, Sudhindran Surendran3, Uma Devi Padma2*
1Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi - 682041, Kerala, India.
2Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi - 682041, Kerala, India.
3Department of Gastrointestinal Surgery, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Kochi - 682041, Kerala, India.
Volume - 14,
Issue - 4,
Year - 2021
This prospective, pilot study evaluated the effect of immunonutrition supplementation using Pentasure Immunomax® on recovery after major gastrointestinal (GI) surgery for malignancy. It included two groups of patients (n = 25 each) who underwent major GI surgery for malignancy in two units, one of which routinely gave Pentasure Immunomax® (L – arginine, omega 3 fatty acids and ribonucleic acids) for two weeks following surgery (Group 1) while the other did not (Group 2). The pre-operative nutritional status of the patients were assessed using Subjective Global Assessment (SGA) scale. Post-operatively the following parameters were compared between the two groups: complications (using Clavien Dindo scale), calorie intake, length of intensive care unit (ICU) and hospital stay using SPSS software, version 20.0. Based on the SGA score, 66% of the entire study population was moderately malnourished, while 6% were severely malnourished. On assessing the body mass index, 26 (52%) patients were found to be overweight or obese, out of which 16 patients were found to be moderately malnourished. The mean caloric intake in Group 1 was significantly more than in Group 2 (1112.7± 51.6 versus 874.8±56.7; p = 0.0032). There was, however, no significant difference between the two groups in complications, ICU or hospital stay. The incidence of malnutrition in patients undergoing major GI surgery for malignancy is high even amongst those who are overweight/obese. Use of immunonutrition may help in better attainment of adequate calorie in post-operative period.
Cite this article:
Saraswathy Sivaprasadan, Anju Kochupurackal Paul, Sudhindran Surendran, Uma Devi Padma. Effect of Immunonutrition supplementation on Post-operative outcome after major Gastrointestinal surgery for Malignancy. Research Journal of Pharmacy and Technology. 2021; 14(4):2258-1. doi: 10.52711/0974-360X.2021.00399
Saraswathy Sivaprasadan, Anju Kochupurackal Paul, Sudhindran Surendran, Uma Devi Padma. Effect of Immunonutrition supplementation on Post-operative outcome after major Gastrointestinal surgery for Malignancy. Research Journal of Pharmacy and Technology. 2021; 14(4):2258-1. doi: 10.52711/0974-360X.2021.00399 Available on: https://rjptonline.org/AbstractView.aspx?PID=2021-14-4-75
1. Santarpia L, et al. Nutritional screening and early treatment of malnutrition in cancer patients. Journal of Cachexia Sarcopenia Muscle. 2011; 2(1): 27-35.
2. Silpa KS, et al. Malnutrition in cancer patients undergoing chemotherapy. Journal of Cancer Research & Therapeutics. 2017; 13 Suppl: S247.
3. Lohsiriwat V. The influence of preoperative nutritional status on the outcomes of an enhanced recovery after surgery (ERAS) programme for colorectal cancer surgery. Techniques in Coloproctology. 2014; 18(11): 1075-1080.
4. Garth AK, et al. Nutritional status, nutrition practices and post-operative complications in patients with gastrointestinal cancer. Journal of Human Nutrition and Dietetics. 2010; 23(4): 393-401.
5. Calder PC. Immunonutrition: May have beneficial effects in surgical patients. British Medical Journal. 2003; 327: 117–118.
6. Grimble RF. Basics in clinical nutrition: Immunonutrition – Nutrients which influence immunity: Effect and mechanism of action. e-SPEN, the European e-Journal of Clinical Nutrition and Metabolism. 2009; 4: e10-13.
7. Braga M, et al. Gut function and immune and inflammatory responses in patients perioperatively fed with supplemented enteral formulas. Archives of Surgery. 1996; 131(12): 1257-1264; discussion 1264-1265.
8. Weimann A, et al. ESPEN guideline: Clinical nutrition in surgery. Clinical Nutrition. 2017; 36(3): 623-650.
9. Shpata V, et al. Malnutrition at the time of surgery affects negatively the clinical outcome of critically ill patients with gastrointestinal cancer. Medical Archives. 2014; 68(4): 263-267.
10. Daly JM, et al. Enteral nutrition with supplemental arginine, RNA, and omega-3 fatty acids in patients after operation: immunologic, metabolic, and clinical outcome. Surgery. 1992; 112(1): 56-67.
11. Heslin MJ, et al. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy. Annals of Surgery. 1997; 226(4): 567-577; discussion 577-580.
12. Cheng Y, et al. Enteral immunonutrition versus enteral nutrition for gastric cancer patients undergoing a total gastrectomy: a systematic review and meta-analysis. BMC Gastroenterology. 2018; 18: 11.