Abstract:
BACKGROUND AND AIM:Immunomodulating nutrition is supposed to reduce the number of complications and lengthen of hospital stay during the postoperative period in patients after major gastrointestinal surgery. The aim of the study was to assess the clinical effect of immunostimulatory enteral and parenteral nutrition in patients undergoing resection for gastrointestinal cancer in the group of well-nourished patients. MATERIAL AND METHODS:Between June 1, 2001, and December 31, 2005, a group of 214 well-nourished patients was initially assessed (150 men, 64 women, mean age 61.2 years) to participate in the study. Nine patients were subsequently excluded and the remaining 205 subjects were randomly assigned in a 2 x 2 factorial design into 4 study groups, ie, standard enteral nutrition (n = 53), immunomodulating enteral nutrition (n = 52), standard parenteral nutrition (n = 49), and immunomodulating enteral nutrition (n = 51). The study was designed to test the hypothesis that immunonutrition and enteral nutrition would reduce the incidence of infectious complications after upper gastrointestinal surgery; the secondary objective of the study was to evaluate the effect of nutritional intervention on overall morbidity and mortality rates, and hospital stay. The study was registered in the Clinical Trials Database-number NCT 00558155. RESULTS:The overall morbidity rate was 33% and the incidence of individual complications was comparable between all groups. Infectious complications occurred in 26 of 102 patients given standard diets and in 22 of 103 patients receiving immunomodulatory formulas (odds ratio 0.81; 95% CI, 0.43-1.50). There were no significant differences between infectious complications in patients using parenteral nutrition (22 of 100 patients) and parenteral formulas (26 of 105, odds ratio 1.14; 95% CI, 0.61-2.14). Neither immunostimulating formulas nor enteral feeding significantly affected secondary outcome measures, including overall morbidity and mortality rates, and hospital stay. CONCLUSIONS:Our study failed to demonstrate any clear advantage of routine postoperative immunonutrition in patients undergoing elective upper gastrointestinal surgery. Both enteral and parenteral treatment options showed similar efficacy, tolerance, and effects on protein synthesis. Parenteral nutrition composed according to contemporary rules showed similar efficiency to enteral nutrition. However, because of its cost-efficiency, enteral therapy should be considered as the treatment of choice in all patients requiring nutritional therapy.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Klek S,Kulig J,Sierzega M,Szybinski P,Szczepanek K,Kubisz A,Kowalczyk T,Gach T,Pach R,Szczepanik AMdoi
10.1097/SLA.0b013e318180a3c1subject
Has Abstractpub_date
2008-08-01 00:00:00pages
212-20issue
2eissn
0003-4932issn
1528-1140pii
00000658-200808000-00010journal_volume
248pub_type
杂志文章,随机对照试验abstract::The University of Rochester, Department of Surgery, in response to an experimental community-wide limit on hospital budgets, studied high-cost general surgical patients as a potential source of leverage for containment of hospital costs. It was found that a small number of patients impact significantly on hospital cos...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198309000-00005
更新日期:1983-09-01 00:00:00
abstract::Patients recovering from acute respiratory insufficiency are usually not extubated until they can ventilate adequately while breathing spontaneously at ambient end-expiratory pressure (T-tube). It is hypothesized that this period of T-tube breathing might be detrimental to gas exchange since the endotracheal tube abol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198005000-00004
更新日期:1980-05-01 00:00:00
abstract:OBJECTIVE/BACKGROUND:There is a high risk of relapse in stage IIIB/IIIC melanoma. The utility of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose positron emission tomography integrated with computed tomography (FDG-PET/CT) in these patients to evaluate response to treatment or for surveillance after treatment is currently not...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0b013e318256d1f5
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:To characterize national trends in procedural management of renal trauma. BACKGROUND:Management of renal trauma has evolved to favor a more conservative approach. For patients requiring intervention, there is a paucity of information to characterize the nature of procedural therapy administered. METHODS:A r...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002475
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Postcholecystectomy complex bile duct injuries involving the hilar confluence, which are often associated with vascular injuries and liver atrophy, remain a considerable surgical challenge. The aim of this study is to report our experience of major hepatectomy with long-term outcome in these patients. METHO...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31817b65f2
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to compare the hand-sewn and stapled methods in esophagogastric anastomosis. SUMMARY BACKGROUND DATA:After esophageal resection for cancer, the relative merits of the hand-sewn and the stapled methods of esophagogastric anastomosis, especially regarding leakage and stricture r...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199708000-00008
更新日期:1997-08-01 00:00:00
abstract:OBJECTIVE:To determine overall survival and disease-free survival in selected patients with nonresectable liver-only colorectal cancer receiving liver transplantation. BACKGROUND:Patients with nonresectable colorectal cancer receiving palliative chemotherapy has a 5-year overall survival of about 10%. Liver transplant...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/SLA.0000000000003404
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:To determine the effects of recombinant human insulin-like growth factor-1 (IGF-1) complexed with its principal binding protein, IGFBP-3, on skeletal muscle metabolism in severely burned children. SUMMARY BACKGROUND DATA:Severe burns are associated with a persistent hypermetabolic response characterized by h...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199905000-00014
更新日期:1999-05-01 00:00:00
abstract::Ventral anomalies of accessory pulmonary tissue have been classified as "bronchopulmonary foregut malformations." Between July 1, 1981, and May 31, 1985, 10 children with bronchopulmonary malformations have been cared for on the Pediatric Surgical Service at the University of Virginia. Six patients had bronchogenic cy...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198605000-00011
更新日期:1986-05-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of remote ischemic conditioning (RIC) on organ protection after hemorrhagic shock/resuscitation (S/R) in a murine model. BACKGROUND:Ischemia/reperfusion resulting from S/R contributes to multiple organ dysfunction in trauma patients. We hypothesized that RIC before shock (remote isch...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000877
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the potential of postischemic intravenous infusion of the endogenous antioxidant glutathione (GSH) to protect the liver from reperfusion injury following prolonged warm ischemia. BACKGROUND DATA:The release of reactive oxygen species (ROS) by activated Kupffer cells (KC) and leukocytes causes rep...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000110321.64275.95
更新日期:2004-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of a novel 2-stage treatment with reductive surgery plus percutaneous isolated hepatic perfusion (PIHP) for multiple hepatocellular carcinoma (HCC), which was previously unresectable. SUMMARY BACKGROUND DATA:Surgical resection is the treatment of choice for HCC, but the majority of p...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/01.sla.0000103133.03688.3d
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVES:Immediate breast reconstruction (IBR) after mastectomy for cancer has increased in recent years, yet long-term, modality-specific comparative data are lacking. We performed this study to compare short- and long-term outcomes after expander, autologous (AT), and direct-to-implant (DI) breast reconstruction. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001457
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To determine if phospholipase A2 (PLA2) type II and type IV mRNA expression and protein are altered in chronic pancreatitis. SUMMARY BACKGROUND DATA:PLA2s have an important regulatory function in several signaling pathways, especially in inflammation. In this study, we examined the expression of three PLA2 i...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199802000-00011
更新日期:1998-02-01 00:00:00
abstract:OBJECTIVE:To establish criteria for venous reconstruction of middle hepatic vein (MHV) tributaries of the right liver graft in adult-to-adult living donor liver transplantation (LDLT). SUMMARY BACKGROUND DATA:In adult LDLT using the right hemiliver, the MHV is usually separated from the graft, which results in potenti...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章
doi:10.1097/00000658-200208000-00013
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVE:This study aimed at: (1) documenting the evolution of surgical results of esophagectomy in a high-volume center, (2) identifying predictive factors of pulmonary complications and mortality, and (3) examining whether preoperative chemoradiation therapy would complicate postoperative recovery. SUMMARY BACKGROU...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000143123.24556.1c
更新日期:2004-11-01 00:00:00
abstract:BACKGROUND:Surgical management of incidental Meckel's diverticulum(MD) is a highly debated controversial issue that has never been discussed from the oncological standpoint. OBJECTIVE:To describe the epidemiology and risk of Meckel's diverticulum cancer (MDC) and compare it with other ileal malignancies. METHODS:Data...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181ef488d
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To assess the relevance of the International Study Group of Liver Surgery (ISGLS) definition of posthepatectomy liver failure compared with 2 well-established criteria, 50-50 and PeakBili>7, as early predictors of posthepatectomy outcome. BACKGROUND:There is limited data on the postoperative use of ISGLS def...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000944
更新日期:2014-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to create a technical skills assessment toolbox for 35 basic and advanced skills/procedures that comprise the American College of Surgeons (ACS)/Association of Program Directors in Surgery (APDS) surgical skills curriculum and to provide a critical appraisal of the included tools...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0000000000000520
更新日期:2015-02-01 00:00:00
abstract::CLINICAL AND LABORATORY STUDIES OF AFP PRODUCING HEPATOMAS DEMONSTRATED THAT: 1) serum AFP levels correlated directly with tumor growth; 2) circulating AFP could be cleared by passive administration of an. excess of anti-AFP; and 3) highly specific anti-AFP functioned as a carrier to localize diagnostic and possibly t...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00025
更新日期:1974-10-01 00:00:00
abstract::The records of 161 adult patients who underwent a modification of the Witzel gastrostomy without gastropexy at Ellis Fischel State Cancer Hospital, Columbia, Missouri, between 1977 and 1980, are reviewed in detail and form the basis of this report. Six of these patients had gastrostomies on two different occasions. Th...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198206000-00003
更新日期:1982-06-01 00:00:00
abstract:OBJECTIVE:To review the literature on current management of hepatocellular carcinoma (HCC). BACKGROUND:Hepatocellular carcinoma represents one of the most common malignancies worldwide with a rising incidence in western countries. There have been substantial advances in the surgical and medical treatment of HCC within...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e31820d944f
更新日期:2011-03-01 00:00:00
abstract::In order to determine which factors most influence late survival after the coronary bypass procedure, a review was made of the initial experience of one surgeon who performed 792 operations between 1968 and 1972. The initial 250 patients were compared with the subsequent 542 patients. The two groups were of similar ag...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197806000-00013
更新日期:1978-06-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of mesh fixation with fibrin sealant (FS) in laparoscopic preperitoneal inguinal hernia repair and to compare it with stapled fixation. SUMMARY BACKGROUND DATA:Laparoscopic hernia repair involves the fixation of the prosthetic mesh in the preperitoneal space with staples to avoid dis...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-200101000-00004
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Liver resection is performed for many types of malignancies. Few reports document actual long-term survival. METHODS:Long-term follow-up of a series of 548 liver resections performed between 1970 and 1992 was performed and is presented. RESULTS:All patients were followed for at least 15 years after surgery...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181b59491
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:Splitting of the liver at the line of Cantlie of otherwise healthy people is accepted worldwide as a reasonable procedure for the donors in adult living donor liver transplantation. A similar operation is still considered as experimental if performed in the deceased donor liver. The aim of this study is to ev...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000189120.62975.0d
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine inguinal hernia recurrence rates 5 years after endoscopic totally extraperitoneal (TEP) inguinal hernia repair when either lightweight or heavyweight mesh was used. BACKGROUND:Recurrence is an important complication of inguinal hernia surgery. Higher recurrence rates of...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002649
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:The aim of the study was to evaluate and study the full spectrum of swallowing dysfunction and long-term disease-specific outcomes in adults with surgically corrected esophageal atresia/tracheaesophageal fistula (EA/TEF). BACKGROUND:Long-term outcomes for adults who underwent EA/TEF repair because infants a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001978
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To develop a model of established respiratory immunity against Pseudomonas aeruginosa pneumonia and to investigate the effects of route and type of nutrition on this immunity. SUMMARY BACKGROUND DATA:Diet influences the ability of gut-associated lymphoid tissue (GALT) to maintain mucosal immunity. Complex en...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199902000-00016
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:This multicenter study sought to evaluate the accuracy of the American College of Surgeons National Surgical Quality Improvement Program's (ACS-NSQIP) surgical risk calculator for predicting outcomes after pancreatoduodenectomy (PD) and to determine whether incorporating other factors improves its predictive ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000001796
更新日期:2017-05-01 00:00:00