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Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes

Background: The aim of this study was to determine the phagocytic activity of thrombocytes in patients with gastric cancer and to assess the effect of oral and parenteral preoperative glutamine-based immunonutrition on nutritional status, thrombocyte phagocytic activity, and early postoperative outc...

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Autores principales: Kamocki, Zbigniew, Matowicka-Karna, Joanna, Jurczuk, Anna, Milewska, Anna, Niewinski, Amanda, Zareba, Konrad, Kedra, Boguslaw
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343864/
https://www.ncbi.nlm.nih.gov/pubmed/37447236
http://dx.doi.org/10.3390/nu15132911
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author Kamocki, Zbigniew
Matowicka-Karna, Joanna
Jurczuk, Anna
Milewska, Anna
Niewinski, Amanda
Zareba, Konrad
Kedra, Boguslaw
author_facet Kamocki, Zbigniew
Matowicka-Karna, Joanna
Jurczuk, Anna
Milewska, Anna
Niewinski, Amanda
Zareba, Konrad
Kedra, Boguslaw
author_sort Kamocki, Zbigniew
collection PubMed
description Background: The aim of this study was to determine the phagocytic activity of thrombocytes in patients with gastric cancer and to assess the effect of oral and parenteral preoperative glutamine-based immunonutrition on nutritional status, thrombocyte phagocytic activity, and early postoperative outcomes. Methods: Patients suffering from invasive gastric cancer had been treated with preoperative immunonutrition with glutamine, and they were compared to patients without nutritional treatment. Nutritional status, percentage of weight loss, and BMI were assessed. Levels of total protein, albumin, cholesterol, triglycerides, platelets, and their phagocytic ability were measured twice. Postsurgical complications were assessed via the Clavien–Dindo classification. Results: Group I consisted of 20 patients with an oral glutamine—10 g daily. Group II had 38 patients who received intravenous glutamine, 1.5 mL per kg body weight of Dipeptiven. Group III consisted of 25 patients who did not receive preoperative immunonutrition. In total, 47% of patients in Group I, 54% of patients in Group II, and 33% of patients in Group III were malnourished. In Group I, the percentage of phagocytizing platelet (%PhP) was 1.1 preoperatively and 1.2 postoperatively. The phagocytic index (PhI) was 1.0 and 1.1. In Group II, %PhP was 1.1 and 1.2 and PhI was 1.0 and 1.1. In Group III, the %PhP was 1.0 and 1.2 and PhI was 1.0 and 1.1. An increase in triglyceride level was observed in both immunonutrition groups. There was a decline in total protein and albumin level in Group II. In Group III, there was a decline in total protein, albumin, and cholesterol level. The total platelet count and PhI were increased in both immunonutrition groups. There was also a rise in %PhP in Group II. In Group III, there was a rise in blood platelet level, %PhP, and PhI. The complication rates were 53% in Group I, 29% in Group II, and 40% in Group III. Conclusions: In invasive gastric cancer, laboratory nutritional parameters are significantly reduced, causing malnutrition in 44.7% of patients. Oral glutamine supplementation inhibited the postoperative decline in protein metabolism parameters; however, this did not affect the reduction in the percentage of postoperative complications. Glutamine used preoperatively significantly reduced the percentage of serious surgical complications, regardless of the way it was supplemented. Patients with invasive gastric cancer have a significant decrease in platelet phagocytic activity. The administered preoperative parenteral nutrition and the surgical procedure itself influenced the improvement of the phagocytic activity of blood platelets. Glutamine did not have this effect, regardless of the route of administration.
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spelling pubmed-103438642023-07-14 Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes Kamocki, Zbigniew Matowicka-Karna, Joanna Jurczuk, Anna Milewska, Anna Niewinski, Amanda Zareba, Konrad Kedra, Boguslaw Nutrients Article Background: The aim of this study was to determine the phagocytic activity of thrombocytes in patients with gastric cancer and to assess the effect of oral and parenteral preoperative glutamine-based immunonutrition on nutritional status, thrombocyte phagocytic activity, and early postoperative outcomes. Methods: Patients suffering from invasive gastric cancer had been treated with preoperative immunonutrition with glutamine, and they were compared to patients without nutritional treatment. Nutritional status, percentage of weight loss, and BMI were assessed. Levels of total protein, albumin, cholesterol, triglycerides, platelets, and their phagocytic ability were measured twice. Postsurgical complications were assessed via the Clavien–Dindo classification. Results: Group I consisted of 20 patients with an oral glutamine—10 g daily. Group II had 38 patients who received intravenous glutamine, 1.5 mL per kg body weight of Dipeptiven. Group III consisted of 25 patients who did not receive preoperative immunonutrition. In total, 47% of patients in Group I, 54% of patients in Group II, and 33% of patients in Group III were malnourished. In Group I, the percentage of phagocytizing platelet (%PhP) was 1.1 preoperatively and 1.2 postoperatively. The phagocytic index (PhI) was 1.0 and 1.1. In Group II, %PhP was 1.1 and 1.2 and PhI was 1.0 and 1.1. In Group III, the %PhP was 1.0 and 1.2 and PhI was 1.0 and 1.1. An increase in triglyceride level was observed in both immunonutrition groups. There was a decline in total protein and albumin level in Group II. In Group III, there was a decline in total protein, albumin, and cholesterol level. The total platelet count and PhI were increased in both immunonutrition groups. There was also a rise in %PhP in Group II. In Group III, there was a rise in blood platelet level, %PhP, and PhI. The complication rates were 53% in Group I, 29% in Group II, and 40% in Group III. Conclusions: In invasive gastric cancer, laboratory nutritional parameters are significantly reduced, causing malnutrition in 44.7% of patients. Oral glutamine supplementation inhibited the postoperative decline in protein metabolism parameters; however, this did not affect the reduction in the percentage of postoperative complications. Glutamine used preoperatively significantly reduced the percentage of serious surgical complications, regardless of the way it was supplemented. Patients with invasive gastric cancer have a significant decrease in platelet phagocytic activity. The administered preoperative parenteral nutrition and the surgical procedure itself influenced the improvement of the phagocytic activity of blood platelets. Glutamine did not have this effect, regardless of the route of administration. MDPI 2023-06-27 /pmc/articles/PMC10343864/ /pubmed/37447236 http://dx.doi.org/10.3390/nu15132911 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kamocki, Zbigniew
Matowicka-Karna, Joanna
Jurczuk, Anna
Milewska, Anna
Niewinski, Amanda
Zareba, Konrad
Kedra, Boguslaw
Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes
title Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes
title_full Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes
title_fullStr Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes
title_full_unstemmed Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes
title_short Preoperative Glutamine Supplementation in Gastric Cancer—Thrombocyte Phagocytic Activity and Early Postoperative Outcomes
title_sort preoperative glutamine supplementation in gastric cancer—thrombocyte phagocytic activity and early postoperative outcomes
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343864/
https://www.ncbi.nlm.nih.gov/pubmed/37447236
http://dx.doi.org/10.3390/nu15132911
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