Abstract
Omega-3 fatty acid supplemented total parenteral nutrition improves the clinical outcome of patients undergoing certain operations; however, its benefits for patients with hepatitis type B virus (HBV)-associated hepatocellular carcinoma (HCC) who have undergone hepatectomy are still not clear. The aim of this study was to evaluate the effect of omega-3 fatty acid supplemented total parenteral nutrition on the clinical outcome of patients with HBV-associated HCC who underwent hepatectomy at our institution. A total of 63 patients with HBV-associated HCC who underwent hepatectomy were included in this study. These patients were randomly assigned to receive standard total parenteral nutrition (the control group, n = 31) or omega-3 fatty acid supplemented total parenteral nutrition (the omega-3 fatty acid group, n = 32) for at least 5 d. The study endpoints were the occurrence of infection-related complications, recovery of liver function and length of hospital stay. The results showed that the omega-3 fatty acid group had a lower infection rate (omega-3 fatty acid, 19.4% vs control, 43.8%, P < 0.05), a better liver function after hepatectomy: alanine transaminase (omega-3 fatty acid, 48.23±18.48 U/L vs control, 73.34±40.60 U/L, P < 0.01), aspartate transaminase (omega-3 fatty acid, 35.77±14.56 U/L vs control, 50.53±24.62 U/L, P < 0.01), total bilirubin (omega-3 fatty acid, 24.29±7.40 mmol/L vs control, 28. 37±8.06 mmol/L, P < 0.05) and a shorter length of hospital stay (omega-3 fatty acid, 12.71±2.58 d vs control, 15.91±3.23 d, P < 0.01). The serum contents of IL-6 (omega-3 fatty acid, 23.98±5.63 pg/mL vs control, 35.55±7.5 pg/mL, P < 0.01) and TNF-α (omega-3 fatty acid, 4.43±1.22 pg/mL vs control, 5.96±1.58 pg/mL, P < 0.01) after hepatectomy were significantly lower in the omega-3 fatty acid group than those of the control group. In conclusion, administration of omega-3 fatty acid may reduce infection rate and improve liver function recovery in HBV-associated HCC patients after hepatectomy. This improvement is associated with suppressed production of proinflammatory cytokines in these patients.
Highlights
Lipids are key energy sources in critically ill patients due to their high energy density, low osmolarity, and preferred utilization during the systemic inflammatory response
Using a high-dose short-term infusion of omega-3 fatty acid lipid emulsion may cause rapid immunologic changes, through which the effects on the endotoxin-induced stress response may be achieved. In this randomized controlled study, we evaluated the effect of omega-3 fatty acid-supplemented total parenteral nutrition (TPN) on the clinical outcomes of patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) after hepatectomy
A recent metaanalysis showed that use of Omega-3 fatty acid lipid emulsions which are rich in omega-3 fatty acids may reduce ventilation time, mortality, antibiotic demand, and length of hospital stay in surgical patients[12]
Summary
Lipids are key energy sources in critically ill patients due to their high energy density, low osmolarity, and preferred utilization during the systemic inflammatory response. Recent studies have indicated that omega-3 fatty acids are safe for cancer patients and play a very important role for patients who need total parenteral nutrition (TPN)[6,7,8,9,10]. Using a high-dose short-term infusion of omega-3 fatty acid lipid emulsion may cause rapid immunologic changes, through which the effects on the endotoxin-induced stress response may be achieved. In this randomized controlled study, we evaluated the effect of omega-3 fatty acid-supplemented TPN on the clinical outcomes of patients with hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC) after hepatectomy
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