Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal Metastasis
The effect of preoperative immunonutrition intake on postoperative major complications in patients following cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) was assessed. The accuracy of C-Reactive Protein (CRP) for detecting postoperative complications...
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MDPI AG
2021-06-01
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| Series: | Nutrients |
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| Online Access: | https://www.mdpi.com/2072-6643/13/7/2147 |
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| author | Alba Fernández-Candela Alicia Calero Luís Sánchez-Guillén Javier Escrig-Sos José A. Barreras Francisco López-Rodríguez-Arias Laura Armañanzas Ana Murcia Antonio Arroyo Francisco Javier Lacueva |
| author_facet | Alba Fernández-Candela Alicia Calero Luís Sánchez-Guillén Javier Escrig-Sos José A. Barreras Francisco López-Rodríguez-Arias Laura Armañanzas Ana Murcia Antonio Arroyo Francisco Javier Lacueva |
| author_sort | Alba Fernández-Candela |
| collection | DOAJ |
| description | The effect of preoperative immunonutrition intake on postoperative major complications in patients following cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) was assessed. The accuracy of C-Reactive Protein (CRP) for detecting postoperative complications was also analyzed. Patients treated within a peritoneal carcinomatosis program in which a complete or optimal cytoreduction was achieved were retrospectively analyzed. They were divided into two groups based on whether preoperative immunonutrition (IMN) or not (non-IMN) were administered. Clinical and surgical variables and postoperative complications were gathered. Predictive values of major morbidity of CRP during the first 3 postoperative days (POD) were also evaluated. A total of 107 patients were included, 48 belonging to the IMN group and 59 to the non-IMN group. In multivariate analysis immunonutrition (OR 0.247; 95%CI 0.071–0.859; <i>p</i> = 0.028), and the number of visceral resections (OR 1.947; 95%CI 1.086–3.488; <i>p</i> = 0.025) emerged as independent factors associated with postoperative major morbidity. CRP values above 103 mg/L yielded a negative predictive value of 84%. Preoperative intake of immunonutrition was associated with a decrease of postoperative major morbidity and might be recommended to patients with peritoneal carcinomatosis following CRS. Measuring CRP levels during the 3 first postoperative days is useful to rule out major morbidity. |
| first_indexed | 2024-03-10T10:09:34Z |
| format | Article |
| id | doaj.art-438021248b6c4850990544df1930de4f |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T10:09:34Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-438021248b6c4850990544df1930de4f2023-11-22T01:18:34ZengMDPI AGNutrients2072-66432021-06-01137214710.3390/nu13072147Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal MetastasisAlba Fernández-Candela0Alicia Calero1Luís Sánchez-Guillén2Javier Escrig-Sos3José A. Barreras4Francisco López-Rodríguez-Arias5Laura Armañanzas6Ana Murcia7Antonio Arroyo8Francisco Javier Lacueva9Peritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, SpainPeritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, SpainPeritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, SpainDepartment of Medicine, University Jaume I (UJI), 12004 Valencia, SpainPeritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, SpainPeritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, SpainPeritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, SpainPharmacy Department, Elche University General Hospital, 03202 Elche, SpainPeritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, SpainPeritoneal Carcinomatosis Unit, General Surgery Department, Elche University General Hospital, 03202 Elche, SpainThe effect of preoperative immunonutrition intake on postoperative major complications in patients following cytoreductive surgery (CRS) with or without hyperthermic intraperitoneal chemotherapy (HIPEC) was assessed. The accuracy of C-Reactive Protein (CRP) for detecting postoperative complications was also analyzed. Patients treated within a peritoneal carcinomatosis program in which a complete or optimal cytoreduction was achieved were retrospectively analyzed. They were divided into two groups based on whether preoperative immunonutrition (IMN) or not (non-IMN) were administered. Clinical and surgical variables and postoperative complications were gathered. Predictive values of major morbidity of CRP during the first 3 postoperative days (POD) were also evaluated. A total of 107 patients were included, 48 belonging to the IMN group and 59 to the non-IMN group. In multivariate analysis immunonutrition (OR 0.247; 95%CI 0.071–0.859; <i>p</i> = 0.028), and the number of visceral resections (OR 1.947; 95%CI 1.086–3.488; <i>p</i> = 0.025) emerged as independent factors associated with postoperative major morbidity. CRP values above 103 mg/L yielded a negative predictive value of 84%. Preoperative intake of immunonutrition was associated with a decrease of postoperative major morbidity and might be recommended to patients with peritoneal carcinomatosis following CRS. Measuring CRP levels during the 3 first postoperative days is useful to rule out major morbidity.https://www.mdpi.com/2072-6643/13/7/2147peritoneal metastasisperitoneal carcinomatosiscytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC)immunonutritionpostoperative complicationsC-reactive protein |
| spellingShingle | Alba Fernández-Candela Alicia Calero Luís Sánchez-Guillén Javier Escrig-Sos José A. Barreras Francisco López-Rodríguez-Arias Laura Armañanzas Ana Murcia Antonio Arroyo Francisco Javier Lacueva Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal Metastasis Nutrients peritoneal metastasis peritoneal carcinomatosis cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) immunonutrition postoperative complications C-reactive protein |
| title | Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal Metastasis |
| title_full | Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal Metastasis |
| title_fullStr | Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal Metastasis |
| title_full_unstemmed | Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal Metastasis |
| title_short | Effect of Preoperative Immunonutrition on Postoperative Major Morbidity after Cytoreductive Surgery and HIPEC in Patients with Peritoneal Metastasis |
| title_sort | effect of preoperative immunonutrition on postoperative major morbidity after cytoreductive surgery and hipec in patients with peritoneal metastasis |
| topic | peritoneal metastasis peritoneal carcinomatosis cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) immunonutrition postoperative complications C-reactive protein |
| url | https://www.mdpi.com/2072-6643/13/7/2147 |
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