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Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy

Background and objectives: Immunonutrition is recommended by enhanced recovery after surgery in patients undergoing pancreatoduodenectomy for 5–7 days perioperatively as it may reduce the rate of infectious complications. However, data on effect of immunonutrition on the overall complication rate ar...

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Autores principales: Tumas, Jaroslav, Jasiūnas, Eugenijus, Strupas, Kęstutis, Šileikis, Audrius
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074545/
https://www.ncbi.nlm.nih.gov/pubmed/31991566
http://dx.doi.org/10.3390/medicina56020052
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author Tumas, Jaroslav
Jasiūnas, Eugenijus
Strupas, Kęstutis
Šileikis, Audrius
author_facet Tumas, Jaroslav
Jasiūnas, Eugenijus
Strupas, Kęstutis
Šileikis, Audrius
author_sort Tumas, Jaroslav
collection PubMed
description Background and objectives: Immunonutrition is recommended by enhanced recovery after surgery in patients undergoing pancreatoduodenectomy for 5–7 days perioperatively as it may reduce the rate of infectious complications. However, data on effect of immunonutrition on the overall complication rate are contradictory and it is not clear, which groups of patients benefit most. The aims of this study are to evaluate the effects of immunonutrition on the overall complication rate and the rate of severe and/or multiple complications in patients with pancreatic tumours stratified according to final histological diagnosis—patients with pancreatic ductal adenocarcinoma (PDAC) vs. other tumours—and nutritional state, using more sensitive Comprehensive Complication Index. Materials and Methods: Seventy consecutive patients scheduled for pancreatoduodenectomy because of pancreatic tumours were randomised into immunonutrition vs. control groups and stratified according to final histological diagnosis and nutritional status. Surgical outcomes were assessed postoperatively using Clavien—Dindo classification (CDC) and Comprehensive Complication Index (CCI). Results: No significant differences in the overall complication rates in immunonutrition vs. control, patients with malnutrition vs. no malnutrition, PDAC vs. other pancreatic tumours groups were detected. However, significant differences in the rates of severe and/or multiple complications in immunonutrition vs. control groups and in PDAC patients segregated according to immunonutrition were obtained using CCI. Conclusions: Patients with PDAC may experience greater benefits of immunonutrition as compared to patients with benign pancreatic diseases or less aggressive tumours, while nutritional status was not a determining factor for the efficacy of immunonutrition.
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spelling pubmed-70745452020-03-20 Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy Tumas, Jaroslav Jasiūnas, Eugenijus Strupas, Kęstutis Šileikis, Audrius Medicina (Kaunas) Article Background and objectives: Immunonutrition is recommended by enhanced recovery after surgery in patients undergoing pancreatoduodenectomy for 5–7 days perioperatively as it may reduce the rate of infectious complications. However, data on effect of immunonutrition on the overall complication rate are contradictory and it is not clear, which groups of patients benefit most. The aims of this study are to evaluate the effects of immunonutrition on the overall complication rate and the rate of severe and/or multiple complications in patients with pancreatic tumours stratified according to final histological diagnosis—patients with pancreatic ductal adenocarcinoma (PDAC) vs. other tumours—and nutritional state, using more sensitive Comprehensive Complication Index. Materials and Methods: Seventy consecutive patients scheduled for pancreatoduodenectomy because of pancreatic tumours were randomised into immunonutrition vs. control groups and stratified according to final histological diagnosis and nutritional status. Surgical outcomes were assessed postoperatively using Clavien—Dindo classification (CDC) and Comprehensive Complication Index (CCI). Results: No significant differences in the overall complication rates in immunonutrition vs. control, patients with malnutrition vs. no malnutrition, PDAC vs. other pancreatic tumours groups were detected. However, significant differences in the rates of severe and/or multiple complications in immunonutrition vs. control groups and in PDAC patients segregated according to immunonutrition were obtained using CCI. Conclusions: Patients with PDAC may experience greater benefits of immunonutrition as compared to patients with benign pancreatic diseases or less aggressive tumours, while nutritional status was not a determining factor for the efficacy of immunonutrition. MDPI 2020-01-24 /pmc/articles/PMC7074545/ /pubmed/31991566 http://dx.doi.org/10.3390/medicina56020052 Text en © 2020 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Tumas, Jaroslav
Jasiūnas, Eugenijus
Strupas, Kęstutis
Šileikis, Audrius
Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy
title Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy
title_full Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy
title_fullStr Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy
title_full_unstemmed Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy
title_short Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy
title_sort effects of immunonutrition on comprehensive complication index in patients undergoing pancreatoduodenectomy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074545/
https://www.ncbi.nlm.nih.gov/pubmed/31991566
http://dx.doi.org/10.3390/medicina56020052
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