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Abstract：
BACKGROUND: Head and neck cancer patients have a high rate of complications during the postoperative period that could increase their morbidity rate. Arginine has been shown to improve healing and to modulate inflammation and immune response. The aim of our study was to assess whether use of arginine-enriched enteral formulas could decrease fistulas and length of stay (LoS).
METHODS: A retrospective study was conducted in patients who had undergone head and neck cancer surgery and were receiving enteral nutrition through a nasogastric tube in the postoperative period between January 2012 and May 2018. The differences associated to use of immunoformula vs. standard formulas were analysed. Sociodemographic, anthropometric, and nutritional intervention variables, as well as nutritional parameters, were recorded during the early postoperative period. Occurrence of complications (fistulas), length of hospital stay, readmissions, and 90-day mortality were recorded.
RESULTS: In a univariate analysis, patients who received nutritional support with immunonutrition had a lower fistula occurrence rate (17.91% vs. 32.84%; p=0.047) and a shorter mean LoS [28.25 (SD 16.11) vs. 35.50 (SD 25.73) days; p=0.030]. After adjusting for age, energy intake, aggressiveness of surgery and tumour stage, fistula occurrence rate and LoS were similar in both groups irrespective of the type of formula.
CONCLUSIONS: Use of arginine-enriched enteral nutrition appears to decrease the occurrence of fistulas in the postoperative period in patients with head and neck cancer, with a resultant reduction in length of hospital stay. However, the differences disappeared after adjusting for age, tumour stage, or aggressiveness of the surgery.
METHODS: A retrospective study was conducted in patients who had undergone head and neck cancer surgery and were receiving enteral nutrition through a nasogastric tube in the postoperative period between January 2012 and May 2018. The differences associated to use of immunoformula vs. standard formulas were analysed. Sociodemographic, anthropometric, and nutritional intervention variables, as well as nutritional parameters, were recorded during the early postoperative period. Occurrence of complications (fistulas), length of hospital stay, readmissions, and 90-day mortality were recorded.
RESULTS: In a univariate analysis, patients who received nutritional support with immunonutrition had a lower fistula occurrence rate (17.91% vs. 32.84%; p=0.047) and a shorter mean LoS [28.25 (SD 16.11) vs. 35.50 (SD 25.73) days; p=0.030]. After adjusting for age, energy intake, aggressiveness of surgery and tumour stage, fistula occurrence rate and LoS were similar in both groups irrespective of the type of formula.
CONCLUSIONS: Use of arginine-enriched enteral nutrition appears to decrease the occurrence of fistulas in the postoperative period in patients with head and neck cancer, with a resultant reduction in length of hospital stay. However, the differences disappeared after adjusting for age, tumour stage, or aggressiveness of the surgery.
摘要：
背景：头颈部癌症患者在术后期间的并发症发生率很高，这可能会增加其发病率。精氨酸已被证明可以改善愈合并调节炎症和免疫反应。我们研究的目的是评估使用富含精氨酸的肠内配方是否可以减少瘘管和住院时间（LoS）。
方法：对2012年1月至2018年5月期间接受头颈部癌症手术并通过鼻胃管接受肠内营养的患者进行了回顾性研究。与使用免疫配方相对应的差异对标准公式进行了分析。社会人口统计学，人体测量学,和营养干预变量，以及营养参数，记录在术后早期。并发症（瘘）的发生，住院时间,再入院,记录90天死亡率.
结果：在单变量分析中，接受免疫营养支持的患者瘘发生率较低(17.91%vs.32.84%；p=0.047）和较短的平均LoS[28.25（SD16.11）与35.50（SD25.73）天；p=0.030]。在调整了年龄之后,能量摄入，手术和肿瘤分期的侵略性，与配方类型无关,两组的瘘管发生率和LoS相似.
结论：使用富含精氨酸的肠内营养似乎可以减少头颈部肿瘤患者术后瘘的发生，从而减少住院时间。然而,在调整了年龄后，差异消失了，肿瘤分期,或者手术的侵略性。
方法：对2012年1月至2018年5月期间接受头颈部癌症手术并通过鼻胃管接受肠内营养的患者进行了回顾性研究。与使用免疫配方相对应的差异对标准公式进行了分析。社会人口统计学，人体测量学,和营养干预变量，以及营养参数，记录在术后早期。并发症（瘘）的发生，住院时间,再入院,记录90天死亡率.
结果：在单变量分析中，接受免疫营养支持的患者瘘发生率较低(17.91%vs.32.84%；p=0.047）和较短的平均LoS[28.25（SD16.11）与35.50（SD25.73）天；p=0.030]。在调整了年龄之后,能量摄入，手术和肿瘤分期的侵略性，与配方类型无关,两组的瘘管发生率和LoS相似.
结论：使用富含精氨酸的肠内营养似乎可以减少头颈部肿瘤患者术后瘘的发生，从而减少住院时间。然而,在调整了年龄后，差异消失了，肿瘤分期,或者手术的侵略性。
