Effect of immunonutrition on infectious complications in low skeletal muscle mass patients after pancreaticoduodenectomy

Furukawa, Arata; Furukawa, Katsunori; Suzuki, Daisuke; Yoshitomi, Hideyuki; Takayashiki, Tsukasa; Kuboki, Satoshi; Miyazaki, Masaru; Ohtsuka, Masayuki

doi:10.1016/j.clnu.2020.04.032

Cited by 10 publications

(11 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…High levels of postoperative inflammation from invasive surgery cause immunodeficiency, although immunonutrition has the opposite consequence of excessive inflammation suppression [ 6 ]. According to one study, preoperative immunonutrition decreased inflammatory cytokines following pancreaticoduodenectomy, which may be responsible for the decrease in postoperative complications [ 41 ]. Ates et al [ 42 ] reported that postoperative administration of immunonutrition resulted in lower postoperative CRP.…”

Section: Discussionmentioning

confidence: 99%

Impact of Perioperative Immunonutrition on Postoperative Outcomes in Patients with Upper Gastrointestinal Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Matsui,

Sagawa,

Inaki

et al. 2024

Nutrients

View full text Add to dashboard Cite

There is no consensus on the efficacy of perioperative immunonutrition in patients with upper gastrointestinal (GI) cancer surgery. We clarified the impact of perioperative immunonutrition on postoperative outcomes in patients with upper GI cancers. We searched MEDLINE (PubMed), MEDLINE (OVID), EMBASE, Cochrane Central Register of Controlled Trials, Web of Science Core Selection, and Emcare from 1981–2022 using search terms related to immunonutrition and upper GI cancer. We included randomized controlled trials. Intervention was defined as immunonutritional therapy, including arginine, n-3 omega fatty acids, or glutamine during the perioperative period. The control was defined as standard nutritional therapy. The primary outcomes were infectious complications, defined as events with a Clavien–Dindo classification grade ≥ II that occurred within 30 days after surgery. After screening, 23 studies were included in the qualitative synthesis and in the quantitative synthesis. The meta-analysis showed that immunonutrition reduced infectious complications (relative risk ratio: 0.72; 95% confidence interval: 0.57–0.92; certainty of evidence: Moderate) compared with standard nutritional therapy. In conclusion, nutritional intervention with perioperative immunonutrition in patients with upper GI cancers significantly reduced infectious complications. The effect of immunonutrition for upper GI cancers in reducing the risk of infectious complications was about 30%.

show abstract

Section: Discussionmentioning

confidence: 99%

Impact of Perioperative Immunonutrition on Postoperative Outcomes in Patients with Upper Gastrointestinal Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Matsui,

Sagawa,

Inaki

et al. 2024

Nutrients

View full text Add to dashboard Cite

show abstract

“…Surgical stress from highly invasive surgery produces high postoperative inflammation, which leads to immunodeficiency, but immunonutrition has the effect of suppressing excessive inflammation 6 . One study reported that preoperative immunonutrition suppressed inflammatory cytokines after pancreaticoduodenectomy, which may be responsible for the decrease in postoperative complications 59 . Another study reported that postoperative administration of immunonutrition resulted in lower postoperative C-reactive protein 39 .…”

Section: Discussionmentioning

confidence: 99%

“… 6 One study reported that preoperative immunonutrition suppressed inflammatory cytokines after pancreaticoduodenectomy, which may be responsible for the decrease in postoperative complications. 59 Another study reported that postoperative administration of immunonutrition resulted in lower postoperative C-reactive protein. 39 These results suggest that preoperative and postoperative administration may reduce inflammation.…”

Section: Discussionmentioning

confidence: 99%

Impact of Perioperative Immunonutrition on Postoperative Outcomes for Patients Undergoing Head and Neck or Gastrointestinal Cancer Surgeries

Matsui,

Sagawa,

Sano

et al. 2023

Annals of Surgery

View full text Add to dashboard Cite

Objective: To clarify whether perioperative immunonutrition is effective in adult patients with or without malnutrition undergoing elective surgery for head and neck or gastrointestinal (GI) cancers. Background: It is important to avoid postoperative complications in patients with cancer as they can compromise clinical outcomes. There is no consensus on the efficacy of perioperative immunonutrition in patients with or without malnutrition undergoing head and neck or GI cancer surgery. Methods: We searched MEDLINE (PubMed), MEDLINE (OVID), EMBASE, Cochrane Central Register of Controlled Trials, Web of Science Core Selection, and Emcare from 1981–2022 using search terms related to immunonutrition and head and neck or GI cancer. We included randomized controlled trials. Intervention was defined as immunonutritional therapy including arginine, n-3 omega fatty acids, or glutamine during the perioperative period. The control was defined as standard nutritional therapy. The primary outcomes were total postoperative and infectious complications, defined as events with a Clavien–Dindo classification grade ≥ II that occurred within 30 days after surgery. Results: Of the 4825 patients from 48 included studies, 19 had upper GI cancer, nine lower, and eight mixed, while 12 had head and neck cancers. Immunonutrition reduced the total postoperative complications (relative risk ratio:0.78; 95% confidence interval:0.66, 0.93; certainty of evidence: high) and infectious complications (relative risk ratio:0.71; 95% confidence interval:0.61, 0.82; certainty of evidence: high) compared with standard nutritional therapy. Conclusions: Nutritional intervention with perioperative immunonutrition in patients with head and neck and gastrointestinal cancers significantly reduced total postoperative complications and infectious complications.

show abstract

“…Furakawa et al [31] assessed the impact of oral IN on infectious complications in low skeletal muscle mass patients after PD, in a retrospective, consecutive cohort study. Skeletal muscle mass was assessed using preoperative computed tomography images in 298 consecutive patients who underwent PD.…”

Section: The Use Of In In Patients Undergoing Pd In the Recent World mentioning

confidence: 99%

“…This is a very important conclusion, because sarcopenia occurs in patients undergoing PD. It may be caused by ageing, cancer, malnutrition, sepsis, and some chronic diseases [31].…”

Section: The Use Of In In Patients Undergoing Pd In the Recent World mentioning

confidence: 99%

The Role of Immunonutrition in Patients Undergoing Pancreaticoduodenectomy

Jabłońska

Mrowiec

2020

Nutrients

View full text Add to dashboard Cite

Pancreaticoduodenectomy (PD) is one of the most difficult and complex surgical procedures in abdominal surgery. Malnutrition and immune dysfunction in patients with pancreatic cancer (PC) may lead to a higher risk of postoperative infectious complications. Although immunonutrition (IN) is recommended for enhanced recovery after surgery (ERAS) in patients undergoing PD for 5–7 days perioperatively, its role in patients undergoing pancreatectomy is still unclear and controversial. It is known that the proper surgical technique is very important in order to reduce a risk of postoperative complications, such as a pancreatic fistula, and to improve disease-free survival in patients following PD. However, it has been proven that IN decreases the risk of infectious complications, and shortens hospital stays in patients undergoing PD. This is a result of the impact on altered inflammatory responses in patients with cancer. Both enteral and parenteral, as well as preoperative and postoperative IN, using various nutrients, such as glutamine, arginine, omega-3 fatty acids and nucleotides, is administered. The most frequently used preoperative oral supplementation is recommended. The aim of this paper is to present the indications and benefits of IN in patients undergoing PD.

show abstract

Effect of immunonutrition on infectious complications in low skeletal muscle mass patients after pancreaticoduodenectomy

Cited by 10 publications

References 34 publications

Impact of Perioperative Immunonutrition on Postoperative Outcomes in Patients with Upper Gastrointestinal Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Impact of Perioperative Immunonutrition on Postoperative Outcomes in Patients with Upper Gastrointestinal Cancer: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Impact of Perioperative Immunonutrition on Postoperative Outcomes for Patients Undergoing Head and Neck or Gastrointestinal Cancer Surgeries

The Role of Immunonutrition in Patients Undergoing Pancreaticoduodenectomy

Contact Info

Product

Resources

About