Outcome and Cost-effectiveness of Perioperative Enteral Immunonutrition in Patients Undergoing Elective Upper Gastrointestinal Tract Surgery

摘要: Hypothesis Perioperatively administered enteral immunonutrition will improve early postoperative morbidity and cost-effectiveness after gastrointestinal tract surgery. Design A prospective, randomized, double-blind, multicenter clinical trial. Setting Surgical departments in German university teaching hospitals. Patients One hundred fifty-four patients with upper malignant neoplasms who were eligible for analysis. Intervention Preoperatively, received 5 days of oral (an arginine-, RNA-, ω3 fatty acid–supplemented diet) or an isoenergetic control diet (1 L/d). Early feeding isoenergetic, isonitrogenous using a catheter jejunostomy was performed 10 days. Main Outcome Measures Postoperative infectious complications, their treatment costs, analyzed. Plasma levels the acids eicosapentaenoic acid docosahexaenoic measured. Results In group, significantly fewer complication events occurred (14 vs 27; P = .05). The number complications lower supplemented group day 3 (7 16; .04). costs suggestively than (DM 75 172 DM 204 273). Cost-effectiveness 1503 experimental 3587 where denotes deutsche mark (German currency). Conclusion perioperative administration ( .05) decreased occurrence infections reduced substantially major