Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2012 Mar;99(3):346-55.
doi: 10.1002/bjs.7799. Epub 2012 Jan 11.

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

J Sultan  1 , S M Griffin, F Di Franco, J A Kirby, B K Shenton, C J Seal, P Davis, Y K S Viswanath, S R Preston, N Hayes
Affiliations
Free PMC article
Randomized Controlled Trial

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

J Sultan et al. Br J Surg. 2012 Mar.
Free PMC article

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).

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
CONSORT diagram for the trial; IED, immunoenhancing diet; SEN, standard enteral nutrition
See this image and copyright information in PMC

References

    1. Griffin SM. Surgery for cancer of the oesophagus. In: Griffin SM, Raimes SA, editors. Oesophagogastric Surgery. 3rd edn. Philadelphia: Elsevier; 2006. pp. 147–149.
    1. McCulloch P, Ward J, Tekkis PP ASCOT group of surgeons; British Oesophago-Gastric Cancer Group. Mortality and morbidity in gastro-oesophageal cancer surgery: initial results of ASCOT multicentre prospective cohort study. BMJ. 2003;327:1192–1197. - PMC - PubMed
    1. Gadek JE, DeMichele SJ, Karlstad MD, Pacht ER, Donahoe M, Albertson TE, et al. Effect of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in patients with acute respiratory distress syndrome. Crit Care Med. 1999;27:1409–1410. - PubMed
    1. Weiss G, Meyer F, Matthies B, Pross M, Koenig W, Lippert H. Immunomodulation by perioperative administration of n-3 fatty acids. Br J Nutr. 2002;87:S89–S94. - PubMed
    1. Andersson R, Andersson B, Andersson E, Eckerwall G, Nordén M, Tingstedt B. Immunomodulation in surgical practice. HPB (Oxford) 2006;8:116–123. - PMC - PubMed

Publication types

MeSH terms

Associated data