Effect of Immunonutrition supplementation on Post-operative outcome after major Gastrointestinal surgery for Malignancy

Abstract

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.