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Randomized clinical trial of omega-3 fatty acid-supplemented enteral nutrition versus standard enteral nutrition in patients undergoing oesophagogastric cancer surgery

Lookup NU author(s): Javed Sultan, Professor Michael Griffin, Emeritus Professor John Kirby, Dr Brian Shenton, Emeritus Professor Chris SealORCiD, Dr Patricia Davis

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Abstract

Background: Oesophagogastric cancer surgery is immunosuppressive. This may be modulated by omega‐3 fatty acids (O‐3FAs). The aim of this study was to assess the effect of perioperative O‐3FAs on clinical outcome and immune function after oesophagogastric cancer surgery. Methods: Patients undergoing subtotal oesophagectomy and total gastrectomy were recruited and allocated randomly to an O‐3FA enteral immunoenhancing diet (IED) or standard enteral nutrition (SEN) for 7 days before and after surgery, or to postoperative supplementation alone (control group). Clinical outcome, fatty acid concentrations, and HLA‐DR expression on monocytes and activated T lymphocytes were determined before and after operation. Results: Of 221 patients recruited, 26 were excluded. Groups (IED, 66; SEN, 63; control, 66) were matched for age, malnutrition and co‐morbidity. There were no differences in morbidity (P = 0·646), mortality (P = 1·000) or hospital stay (P = 0·701) between the groups. O‐3FA concentrations were higher in the IED group after supplementation (P < 0·001). The ratio of omega‐6 fatty acid to O‐3FA was 1·9:1, 4·1:1 and 4·8:1 on the day before surgery in the IED, SEN and control groups (P < 0·001). There were no differences between the groups in HLA‐DR expression in either monocytes (P = 0·538) or activated T lymphocytes (P = 0·204). Conclusion: Despite a significant increase in plasma concentrations of O‐3FA, immunonutrition with O‐3FA did not affect overall HLA‐DR expression on leucocytes or clinical outcome following oesophagogastric cancer surgery. Registration number: ISRCTN43730758 ( http://www.controlled‐trials.com).

Publication metadata

Author(s): Sultan J, Griffin SM, Di Franco F, Kirby JA, Shenton BK, Seal CJ, Davis P, Viswanath YKS, Preston SR, Hayes N

Publication type: Article

Publication status: Published

Journal: British Journal of Surgery

Year: 2012

Volume: 99

Issue: 3

Pages: 346-355

Print publication date: 11/01/2012

ISSN (print): 0007-1323

ISSN (electronic): 1365-2168

Publisher: John Wiley & Sons Ltd.

URL: http://dx.doi.org/10.1002/bjs.7799

DOI: 10.1002/bjs.7799

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