Effect of Immunonutrition on Postoperative Complications in Patients Undergoing Gastrointestinal Cancer Surgery

Background: Immunonutrition not only a nutritional supply for patients but it is a therapy which should be started
as early as possible especially in expected malnutrition following gastrointestinal cancer surgery.
Objectives: To evaluate the effect of immunonutrition on postoperative complications in patients undergoing
gastrointestinal cancer surgery.
Patient and Methods: A prospective randomized trial was carried out on 45 patients who were chosen and
classified randomly into three groups each of them included 15 patients as the followings: Group I received total
parenteral nutrition immediately postoperative for 7 days in the form of carbohydrate, protein, fat (Intralipid 20%),
electrolytes, trace elements and glutamine intravenous in central venous catheter. Group II received nutrition like
group one except that lipid was administered in a new formula containing soya bean oil, medium chain triglyceride,
olive oil and fish oil. Group III received nutrition in the same formula of group II but it was started 7 days
preoperative and continued for 7 days postoperative. Assessment parameters such as body weight and
complications were recorded.
Results: No significant difference between three groups concerning age and sex. A significant effect of time on
body weight collectively was proved. There was a significant group interaction between three groups. Body
weight showed a significant drop both in group I and group III, but not in group II. Concerning postoperative
complications there were no statistical significance between three groups. There was a decrease in the rate of
respiratory tract infection/pneumonia in group III compared to other groups but the decrease was not statistically
significant. Only one case of urinary tract infection was reported in group II and one case of intra-abdominal
infection in group I.
Conclusion: There was a positive impact of parenteral immunonutrition on reduction of postoperative
complications compared to basic caloric requirements (Intralipid postoperative). These findings suggest its use as a
method of choice in patients undergoing gastrointestinal cancer surgery.