Abstract
e19716 Background: Prolonged hospitalization is associated with an increased risk of surgical site infection (SSI) developing as an infectious complication after digestive tract surgery. Such complications are troublesome to the patient as well as the surgeon. Inflammation is an essential component of SSI after major intestinal surgery. The aim of this study was to assess the effect of immune-modulating nutrition on clinical outcomes in patients undergoing elective surgery for gastric and colorectal cancer. Methods: In this prospective, randomized, single-center clinical trial, 330 patients received nutritional supplementation with the ArginaidTM formula (arginine enhanced diet, ISOCALR) before and after elective gastrointestinal cancer surgery between July 2005 and June 2007. One group (Arg-group, 142) received 3 packs of ArginaidTM/day for 2 days before surgery and on postoperative days 4 to 9. The other group (Cont-group, 188) did not receive Arginaid. Clinical variables, postoperative complications, and the length of the hospital stay were recorded. Results: Preoperative characteristics (age, sex, ASA, nutritional status) were similar in the two groups. The rate of postoperative infections and complications did not differ significantly between the Cont-group (23.4%) and Arg-group (22.5%). However, the length of the hospital stay was significantly longer in the Cont-group (17 days) than in the Arg-group (14 days; p<0.0001). On multivariate analysis, a longer hospital stay was associated with lack of nutritional supplementation, advanced age (70 years or older), operation time (5 hours or longer), and wound class and infection. Conclusions: Our results indicate that arginine-rich immunonutritional support suppresses SSI and promotes recovery after surgery in patients with gastric and colorectal cancer. Immune-modulating nutritional treatment effectively decreases and controls surgery-related complications.
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