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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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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. |
format | Online Article Text |
id | pubmed-7074545 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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