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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

MANZANARES, Maria del Carmen; MARTIN, Jesús; AMO-SALAS, Mariano  y  CASANOVA, Daniel. Reduction of postoperative morbidity in programmed colorectal cancer: Preoperative oral immunonutrition. Rev Chil Cir [online]. 2017, vol.69, n.5, pp.389-396. ISSN 0718-4026.  http://dx.doi.org/10.1016/j.rchic.2017.04.001.

Purpose:

Assess the efficacy of preoperative administration of oral immunonutrition in patients with resectable colorectal cancer, in terms of reducing the incidence of postoperative infectious complications.

Material and methods:

Prospective randomized study. A total of 84 patients were recruited. To the group YES IN, Impact© Oral was preoperatively administered for 8 days (3 bricks a day), whereas the NOT IN group only received normal diet, without supplements.

Results:

Of all patients, 40.5% (17) in the NOT IN group suffered infectious complications against 33.3% (14) in the YES IN group. Among patients with rectal cancer in the NOT IN group, 50% (8) suffered minor infectious complications, compared with 13.6% (3) among those in the YES IN group (P = .028). Using logistic regression, the variable total protein on the fifth postoperative day [OR: 2.8 (95% CI: 1.3 to 6.3) (P = .012)] showed a statistically significant relationship with the occurrence of infectious complications. Specifically, anastomotic leak variable behaved as a risk factor in the development of surgical site infection, with an OR of 4.5 (95% CI: 1.3 to 16.1) (P = .033).

Discussion:

Malnutrition in cancer patients suitable for surgery results in an increase in postoperative morbidity and mortality. The use of enteral formulas with immunonutrients in these subjects can attenuate this morbidity, decreasing infectious complications.

Conclusion:

In our analysis, the NOT IN group suffered more postoperative infectious complications, particularly the subset of patients with rectal cancer.

Palabras clave : Colorectal cancer; Malnutrition; Immunonutrition; Infectious complications.

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