Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients

Liang, Bin; Wang, Shan; Ye, Yingjiang; Yang, Xiaodong; Wang, Youli; Qu, Jun; Xie, Qiwei; Yin, Mujun

doi:10.3748/wjg.14.2434

Cited by 120 publications

(149 citation statements)

References 31 publications

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“…The review goes on to describe and interpret studies using parenteral or enteral fish oil in various patient groups with a focus on immune, inflammatory and clinical outcomes. The material described is largely based upon that presented in previous review articles of this subject (1)(2)(3) , but here this information is updated with respect to additional studies of relevance (4) , new meta-analyses (5) and newly published guidelines for parenteral nutrition (6,7) .…”

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confidence: 99%

Rationale and use of n-3 fatty acids in artificial nutrition

Calder

2010

Proc. Nutr. Soc.

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Lipids traditionally used in artificial nutrition are based on n-6 fatty acid-rich vegetable oils like soyabean oil. This may not be optimal because it may present an excessive supply of linoleic acid. One alternative to the use of soyabean oil is its partial replacement by fish oil, which contains n-3 fatty acids. These fatty acids influence inflammatory and immune responses and so may be useful in particular situations where those responses are not optimal. Fish oil-containing lipid emulsions have been used in parenteral nutrition in adult patients post-surgery (mainly gastrointestinal). This has been associated with alterations in patterns of inflammatory mediators and in immune function and, in some studies, a reduction in length of intensive care unit (ICU) and hospital stay. Perioperative administration of fish oil may be superior to post-operative. Parenteral fish oil has been used in critically ill adults. Here the influence on inflammatory processes, immune function and clinical endpoints is not clear, since there are too few studies and those that are available report contradictory findings. Fish oil is included in combination with other nutrients in various enteral formulas. In post-surgical patients and in those with mild sepsis or trauma, there is clinical benefit from a formula including fish oil and arginine. A formula including fish oil, borage oil and antioxidants has demonstrated marked benefits on gas exchange, ventilation requirement, new organ failures, ICU stay and mortality in patients with acute respiratory distress syndrome, acute lung injury or severe sepsis.

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confidence: 99%

Rationale and use of n-3 fatty acids in artificial nutrition

Calder

2010

Proc. Nutr. Soc.

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“…Similar diets have been shown to influence colorectal carcinogenesis [23][24][25] . The present study tested the ability of a hyperlipidic and hypercaloric diet to inhibit the development of ACF in the colonic mucosa of rats treated with AOM.…”

Section: Discussionmentioning

confidence: 99%

Effect of a hyperlipidic diet rich in omegas 3, 6 and 9 on aberrant crypt formation in rat colonic mucosa

Burlamaqui¹,

Dornelas²,

Júnior³

et al. 2012

Acta Cir. Bras.

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PURPOSE: To determine whether a hypercaloric and hyperlipidic diet enriched with polyunsaturated fatty acids influences the formation of aberrant crypt foci (ACF) in colonic mucosa of Wistar rats treated with azoxymethane (AOM). METHODS: At eight weeks of life, the rats were assigned to four groups: Group I―standard diet (STD) not treated with AOM; Group II―hypercaloric and hyperlipidic diet (FED), not treated with AOM; Group III―STD, treated with AOM; Group IV―FED, treated with AOM. At 16 weeks, the animals were injected intraperitoneal with 0.9% saline solution (Group I and II) or AOM at 15mg/Kg (Groups III and IV) once a week for two weeks. Fifteen weeks later, the animals were euthanized. RESULTS: FED promoted weight gain in Groups II and IV compared to Groups I and III, respectively. The groups did not differ with regard to the total number of ACF. The Chi-square test revealed no predominance of the presence of foci with <4 crypts. However, foci with ≥5 crypts were proportionally more prevalent in Group III than in Group IV (p=0.043). CONCLUSION: The administration of polyunsaturated fatty acids did not interfere with the formation of aberrant crypt foci, but reduced ACF multiplicity, exercising an attenuating effect on carcinogenesis.

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“…Figure 1 shows the process for identifying potentially eligible studies and exclusion criteria. After elaborative screening, 34 articles were assessed by full text and 17 studies with 753 patients [2,[10][11][12]15,16,[23][24][25][26][27][28][29][30][31][32][33] were included for the review. However, three publications [2,24,30,31,33] are same study that reported different outcomes.…”

Section: Selection and Characteristics Of Studiesmentioning

confidence: 99%

“…Nine studies reported the occurrence of infectious postoperative complications [11,12,23,26,27,[29][30][31][32]. The incidence of infection was 8.8% in the intervention group (24/273) and 20.1% in the control group (56/271).…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…FO favorably modulates lipid mediator patterns [10][11][12] and the inflammatory response in surgical patients [12,13], reducing the hospital stay [13][14][15] when compared with Long-Chain Triglycerides (LCT) or Long-Chain Triglycerides/Medium-Chain Triglycerides (LCT/MCT). However, there are studies demonstrating that administration of FO (0.2 g/kg per day) after surgical stress is not immunosuppressive, but increases production of IFN-γ, TNF-α, and IL-2 [16].…”

Section: Introductionmentioning

confidence: 99%

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Parenteral Nutrition Enriched with Fish Oil after Gastrointestinal Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Kim¹,

Shin²,

Choi³

2016

Int J Clin Pharmacol Pharmacother

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Objective: We performed a systematic review and meta-analysis to assesses the effects of parenteral nutrition enriched with fish oil versus without fish oil after gastrointestinal surgery. Methods: A search was conducted on Medline, Embase and the Cochrane Library electronic databases. Results: After the review of 17 trials, parenteral nutrition enriched with fish oil improved the infection complications rate (risk ratio (RR) = 0.43; 95% CI: 0.28 to 0.67), length of hospital stay (mean difference (MD) = -1.69; 95% CI: -2, 72 to -0.66) and length of intensive care unit stay (MD = -0.33; 95% CI: -0.51 to -0.14). Other beneficial effects included improvement of liver function AST (MD = -18.25; 95% CI,-30.10 to -6.41), immune function CD 4+ /CD 8+ (MD = 0.16; 95% CI: 0.01 to 0.31), reduction of inflammation markers IL-6 (MD = -7.03; 95% CI: -11.10 to -2.97) and TNF-a (MD = -1.18; 95% CI: -1.71 to -0.66), and increased concentrations of EPA (standard mean difference (SMD) = 5.41; 95% CI: 2.47 to 8.34) and DHA (SMD = 3.20; 95% CI: 1.27 to 5.14). Conclusion: Through these results, we conclude that parenteral nutrition enriched with fish oil is safe and effective. However, further studies in larger patient populations with more extensive investigation are needed to reassess the role of FO.

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Impact of postoperative omega-3 fatty acid-supplemented parenteral nutrition on clinical outcomes and immunomodulations in colorectal cancer patients

Cited by 120 publications

References 31 publications

Rationale and use of n-3 fatty acids in artificial nutrition

Rationale and use of n-3 fatty acids in artificial nutrition

Effect of a hyperlipidic diet rich in omegas 3, 6 and 9 on aberrant crypt formation in rat colonic mucosa

Parenteral Nutrition Enriched with Fish Oil after Gastrointestinal Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

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