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document
Immunoenhanced enteral nutrition formulas in head and neck cancer surgery : a prospective , randomized clinical trial . INTRODUCTION Significant malnutrition exists in a high percentage of patients with head and neck cancer . Malnutrition is associated with defects in immune function that may impair the host response to malignancy . Malnutrition and immunosupression make patients highly susceptible to postoperative infections and complications . OBJECTIVES Compare two immunoenhanced enteral nutritions with a control diet , and evaluate the effect in postoperative infections , length of stay and inflammatory markers . PATIENTS A population of 44 patients with oral and laryngeal cancer was enrolled in a randomized trial . At surgery , patients were randomly allocated to three groups : ( group I ) ; patients receiving an arginine-enhanced formula ( group II ) ; patients receiving a standard polymeric formula , and ( group III ) patients receiving an arginine , RNA and omega-3 fatty acids enhanced formula , in an isonitrogenous way . RESULTS The duration of enteral nutrition in the three groups was similar with an average duration of 14,5 +/- 8 days . The length of postoperative stay was similar , with an average of 19,8 +/- 8,5 days . Wound infections and general infections were more frequent in the control group . Fistula rates were not improved in the enhanced diet groups . No significant intergroup differences in the trend of the two plasma proteins ( albumin , transferrin ) , lymphocytes , weight , IL-6 , CPR and TNFalpha were detected . The control group showed the highest levels of TNFalpha at the fourteenth postoperative day . Gastrointestinal tolerance and diarrhoea rate were similar in all the patients . CONCLUSIONS Immunoenhanced enteral nutrition formulas improved the infection rate in the postoperative of head and neck cancer patients . In the fistula rates , we observed that technical problems and nutritional status might have played an equally important role , and therefore the positive effect of immunonutrition in this parameter might have been overestimated .
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Intervention_Pharmacological
arginine , RNA and omega-3 fatty acids enhanced formula
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Outcome_Physical
postoperative infections , length of stay and inflammatory markers .
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Outcome_Mental
duration of enteral nutrition
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Outcome_Physical
Wound infections and general infections
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Outcome_Other
TNFalpha
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Participant_Condition
cancer
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Participant_Condition
cancer
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Participant_Sample-size
44 patients
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Participant_Condition
oral and laryngeal cancer
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Participant_Condition
cancer