Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy
<i>Background and objectives:</i> Immunonutrition is recommended by enhanced recovery after surgery in patients undergoing pancreatoduodenectomy for 5−7 days perioperatively as it may reduce the rate of infectious complications. However, data on effect of immunonutrition on the...
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MDPI AG
2020-01-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/56/2/52 |
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| author | Jaroslav Tumas Eugenijus Jasiūnas Kęstutis Strupas Audrius Šileikis |
| author_facet | Jaroslav Tumas Eugenijus Jasiūnas Kęstutis Strupas Audrius Šileikis |
| author_sort | Jaroslav Tumas |
| collection | DOAJ |
| description | <i>Background and objectives:</i> Immunonutrition is recommended by enhanced recovery after surgery in patients undergoing pancreatoduodenectomy for 5−7 days perioperatively as it may reduce the rate of infectious complications. However, data on effect of immunonutrition on the overall complication rate are contradictory and it is not clear, which groups of patients benefit most. The aims of this study are to evaluate the effects of immunonutrition on the overall complication rate and the rate of severe and/or multiple complications in patients with pancreatic tumours stratified according to final histological diagnosis—patients with pancreatic ductal adenocarcinoma (PDAC) vs. other tumours—and nutritional state, using more sensitive Comprehensive Complication Index. <i>Materials and Methods:</i> Seventy consecutive patients scheduled for pancreatoduodenectomy because of pancreatic tumours were randomised into immunonutrition vs. control groups and stratified according to final histological diagnosis and nutritional status. Surgical outcomes were assessed postoperatively using Clavien—Dindo classification (CDC) and Comprehensive Complication Index (CCI). <i>Results:</i> No significant differences in the overall complication rates in immunonutrition vs. control, patients with malnutrition vs. no malnutrition, PDAC vs. other pancreatic tumours groups were detected. However, significant differences in the rates of severe and/or multiple complications in immunonutrition vs. control groups and in PDAC patients segregated according to immunonutrition were obtained using CCI. <i>Conclusions:</i> Patients with PDAC may experience greater benefits of immunonutrition as compared to patients with benign pancreatic diseases or less aggressive tumours, while nutritional status was not a determining factor for the efficacy of immunonutrition. |
| first_indexed | 2024-03-12T06:02:31Z |
| format | Article |
| id | doaj.art-17f6c79b1b344ede82e63fb2c3700e69 |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T06:02:31Z |
| publishDate | 2020-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-17f6c79b1b344ede82e63fb2c3700e692023-09-03T03:54:51ZengMDPI AGMedicina1010-660X2020-01-015625210.3390/medicina56020052medicina56020052Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing PancreatoduodenectomyJaroslav Tumas0Eugenijus Jasiūnas1Kęstutis Strupas2Audrius Šileikis3Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, LithuaniaCentre of Informatics and Development, Vilnius University Hospital Santaros Klinikos, 08406 Vilnius, LithuaniaClinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, LithuaniaClinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania<i>Background and objectives:</i> Immunonutrition is recommended by enhanced recovery after surgery in patients undergoing pancreatoduodenectomy for 5−7 days perioperatively as it may reduce the rate of infectious complications. However, data on effect of immunonutrition on the overall complication rate are contradictory and it is not clear, which groups of patients benefit most. The aims of this study are to evaluate the effects of immunonutrition on the overall complication rate and the rate of severe and/or multiple complications in patients with pancreatic tumours stratified according to final histological diagnosis—patients with pancreatic ductal adenocarcinoma (PDAC) vs. other tumours—and nutritional state, using more sensitive Comprehensive Complication Index. <i>Materials and Methods:</i> Seventy consecutive patients scheduled for pancreatoduodenectomy because of pancreatic tumours were randomised into immunonutrition vs. control groups and stratified according to final histological diagnosis and nutritional status. Surgical outcomes were assessed postoperatively using Clavien—Dindo classification (CDC) and Comprehensive Complication Index (CCI). <i>Results:</i> No significant differences in the overall complication rates in immunonutrition vs. control, patients with malnutrition vs. no malnutrition, PDAC vs. other pancreatic tumours groups were detected. However, significant differences in the rates of severe and/or multiple complications in immunonutrition vs. control groups and in PDAC patients segregated according to immunonutrition were obtained using CCI. <i>Conclusions:</i> Patients with PDAC may experience greater benefits of immunonutrition as compared to patients with benign pancreatic diseases or less aggressive tumours, while nutritional status was not a determining factor for the efficacy of immunonutrition.https://www.mdpi.com/1010-660X/56/2/52pancreatic ductal adenocarcinomapancreatoduodenal resectionoutcomespancreatic tumournutritional impairments |
| spellingShingle | Jaroslav Tumas Eugenijus Jasiūnas Kęstutis Strupas Audrius Šileikis Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy Medicina pancreatic ductal adenocarcinoma pancreatoduodenal resection outcomes pancreatic tumour nutritional impairments |
| title | Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy |
| title_full | Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy |
| title_fullStr | Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy |
| title_full_unstemmed | Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy |
| title_short | Effects of Immunonutrition on Comprehensive Complication Index in Patients Undergoing Pancreatoduodenectomy |
| title_sort | effects of immunonutrition on comprehensive complication index in patients undergoing pancreatoduodenectomy |
| topic | pancreatic ductal adenocarcinoma pancreatoduodenal resection outcomes pancreatic tumour nutritional impairments |
| url | https://www.mdpi.com/1010-660X/56/2/52 |
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