Abdülhamit GENCER, YAVUZ ÖZDEMİR, İlker SÜCÜLLÜ, Ali İlker FİLİZ, Ergün YÜCEL, M. Levhi AKIN, Mehmet YILDIZ

Majör abdominal kanser cerrahisi uygulanan hastalarda total parenteral nutrisyon ve enteral immunonutrisyon karşılaştırılması

Amaç: Majör abdominal cerrahi uygulanan olgularda preoperatif başlanan ve erken postoperatif dönemde devam edilen enteral immünonütrisyon ürünü ile total parenteral nütrisyonun, immün sistem ve akut inflamatuar yanıt üzerine etkilerinin araştırılması amaçlandı. Gereç ve Yöntem: Mide ve kolorektal kanser tanılı 60 hasta iki gruba randomize edildi. Birinci gruba enteral immünonütrisyon, ikinci gruba Total Parenteral Nütrisyon uygulandı. Nütrisyonel değerlendirme için albümin, prealbümin, retinol bağlayıcı protein (RBP) ve transferin düzeylerine, immünolojik değerlendirme için IL-2, IL-6, CRP ve T-Lenfosit değerlerine bakıldı. Ayrıca, postoperatif komplikasyon oranları ile yoğun bakım ünitesinde (YBÜ) ve hastanede yatış süreleri karşılaştırıldı. Bulgular: Her iki grupta postoperatif 1. günde nütrisyonel değerlerde anlamlı azalma görüldü (p

The effects of enteral immunonutrient products and total parenteral nutrition in patients who underwent major abdominal surgery

Objective: We aimed to investigate the effects of enteral immunonutrition and Total Parenteral Nutrition (TPN) on the immune system and acute inflammatory response of patients who underwent major abdominal surgery. Material and Methods: Sixty gastric or colorectal cancer patients were randomized into two groups. Enteral immunonutrition was given to the first group and TPN was given to the second group. Albumin, prealbumin, retinol binding globulin (RBP), transferrin, IL-2, IL-6, CRP and T-Lymphocyte levels were determined for nutritional state and immunologic evaluation. Also, postoperative complications, postoperative intensive care unit (ICU) and hospital stays were compared between the two groups. Results: All nutritional parameters were significantly decreased on the postoperative first day in both groups. RBP and prealbumin levels significantly increased in Group I on postoperative day 5. IL-6 and CRP levels increased significantly in both groups. IL-2 levels increased significantly in Group I, T-lymphocyte percentage decreased significantly in Group II on postoperative day 1 and 5. The length of ICU and hospital stays were longer and postoperative infection rate was less in Group II. Conclusion: Decrease in severity of acute inflammatory response and postoperative infection rate, augmentation in cellular immunity, decrease in the length of ICU and hospital stay were observed in the enteral immunonutrition group after major abdominal surgery.

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