N-3 fatty acid-based parenteral nutrition improves postoperative recovery for cirrhotic patients with liver cancer: A randomized controlled clinical trial. Issue 5 (October 2017)

• Record Type: Journal Article
• Authors: Zhang, Binhao; Wei, Gang; Li, Rui; Wang, Yanjun; Yu, Jie; Wang, Rui; Xiao, Hua; Wu, Chao; Leng, Chao; Zhang, Bixiang; Chen, Xiao-ping
• Is Part Of: Clinical nutrition. Volume 36:Issue 5(2017:Oct.)
• Page Start: 1239
• Page End: 1244
• Publication Date: 2017-10
• Subjects: n-3 -- Parenteral nutrition -- Cirrhosis -- Liver cancer -- Hepatectomy; ICGR15 indocyanine green retention rate at 15 min -- ALT alanine aminotransferase -- HBV hepatitis B virus -- FLR future liver remnant -- SLV standardized liver volume -- NRI nutrition risk index -- SGA subjective global assessment -- HCC hepatocellular carcinoma -- Alb Albumin -- WBC white blood cell -- Hgb hemoglobin -- PLT platelets -- TBil total bilirubin -- TC total cholestrol -- TG triglyceride -- BUN blood urea nitrogen -- Cr creatinine -- ΔPT variation of prothrombin time -- Hs-CRP hypersensitive C-reactive protein; Critically ill -- Nutrition -- Periodicals; Diet therapy -- Periodicals; Parenteral feeding -- Periodicals; Enteral feeding -- Periodicals; Enteral Nutrition -- Periodicals; Parenteral Nutrition -- Periodicals; Metabolism -- Periodicals; Diétothérapie -- Périodiques; Alimentation parentérale -- Périodiques; Alimentation entérale -- Périodiques; Nutrition -- Périodiques; Diet therapy; Enteral feeding; Nutrition; Parenteral feeding; Electronic journals; Periodicals; Electronic journals; 615.854
• DOI: 10.1016/j.clnu.2016.08.002
• Languages: English
• ISSNs: 0261-5614

Abstract

Summary: Background & aims: A new lipid emulsion enriched in n-3 fatty acid has been reported to prevent hepatic inflammation in patients following major surgery. However, the role of n-3 fatty acid-based parenteral nutrition for postoperative patients with cirrhosis-related liver cancer is unclear. We investigated the safety and efficacy of n-3 fatty acid-based parenteral nutrition for cirrhotic patients with liver cancer followed hepatectomy. Methods: A prospective randomized controlled clinical trial (Registered under ClinicalTrials.gov Identifier no. NCT02321202 ) was conducted for cirrhotic patients with liver cancer that underwent hepatectomy between March 2010 and September 2013 in our institution. We compared isonitrogenous total parenteral nutrition with 20% Structolipid and 10% n-3 fatty acid (Omegaven, Fresenius-Kabi, Germany) (treatment group) to Structolipid alone (control group) for five days postoperatively, in the absence of enteral nutrition. Results: We enrolled 320 patients, and 312 (97.5%) were included in analysis (155 in the control group and 157 in the treatment group). There was a significant reduction of morbidity and mortality in the treatment group, when compared with the control group (total complications 78 [50.32%] vs. 46 [29.30%]; P < 0.001, total infective complications, 30 [19.35%] vs. 15 [9.55%]; P = 0.014), overall mortality (5 [3.23%] vs. 1 [0.64%]; P = 0.210), and hospital stay (12.56 ± 3.21 d vs. 10.17 ± 3.15 d; P = 0.018). Conclusions: We found that addition of n-3 fatty acid-based parenteral nutrition significantly improved postoperative recovery for cirrhotic patients with liver cancer following hepatectomy, with a significant reduction in overall mortality and length of hospital stay.