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. 2020 Jan 24;56(2):52.
doi: 10.3390/medicina56020052.

Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy

Jaroslav Tumas  1 , Eugenijus Jasiūnas  2 , Kęstutis Strupas  1 , Audrius Šileikis  1
Affiliations

Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy

Jaroslav Tumas et al. Medicina (Kaunas). .

Abstract

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.

Keywords: nutritional impairments; outcomes; pancreatic ductal adenocarcinoma; pancreatic tumour; pancreatoduodenal resection.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Standard deviations (A) and mean (B) of the comprehensive complication index (CCI) in the immunonutrition and control groups (n = 70).
Figure 3
Figure 3
Standard deviations (A) and mean (B) of the comprehensive complication index (CCI) in PDAC patients: immunonutrition vs. control groups (n = 39).
Figure 4
Figure 4
Rate of severe and/ or multiple complications (CCI > 20.9) in immunonutrition vs. control groups (n = 70) (p = 0.006).
Figure 5
Figure 5
Rate of severe and/or multiple complications (CCI > 20.9) in PDAC patients, stratified to immunonutrition vs. control groups (n = 39) (p = 0.04).
See this image and copyright information in PMC

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References

    1. Santilli V., Bernetti A., Mangone M., Paoloni M. Clinical definition of sarcopenia. Clin. Cases Miner. Bone Metab. 2014;11:177–180. doi: 10.11138/ccmbm/2014.11.3.177. - DOI - PMC - PubMed
    1. Jourdan C., Petersen A.K., Gieger C., Döring A., Illig T., Wang-Sattler R., Meisinger C., Peters A., Adamski J., Prehn C., et al. Body fat free mass is associated with the serum metabolite profile in a population-based study. PLoS ONE. 2012;7:e40009. doi: 10.1371/journal.pone.0040009. - DOI - PMC - PubMed
    1. Tomar N., De R.K. Cross Talk Between the Metabolic and Immune Systems. Methods Mol. Biol. 2014;1184:13–21. doi: 10.1007/978-1-4939-1115-8_2. - DOI - PubMed
    1. Braga M., Wischmeyer P.E., Drover J., Heyland D.K. Clinical evidence for pharmaconutrition in major elective surgery. J. Parenter. Enter. Nutr. 2013;37:S66–S72. doi: 10.1177/0148607113494406. - DOI - PubMed
    1. Gaudillière B., Fragiadakis G.K., Bruggner R.V., Nicolau M., Finck R., Tingle M., Silva J., Ganio E.A., Yeh C.G., Maloney W.J., et al. Clinical recovery from surgery correlates with single-cell immune signatures. Sci. Transl. Med. 2014;6:255ra131. doi: 10.1126/scitranslmed.3009701. - DOI - PMC - PubMed