This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Randomized clinical trial of omega‐3 fatty acid‐supplemented enteral nutrition versus standard enteral nutrition in patients undergoing oesophagogastric cancer surgery. BJS 2012; 99: 346-355.
Published: 11th January 2012
Authors: J. Sultan, S. M. Griffin, F. Di Franco, J. A. Kirby, B. K. Shenton, C. J. Seal et al.
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.
Method
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 (