{Reference Type}: Journal Article
{Title}: Postoperative enteral immunonutrition in head and neck cancer patients: Impact on clinical outcomes.
{Author}: Barajas-Galindo DE;Vidal-Casariego A;Pintor-de la Maza B;Fernández-Martínez P;Ramos-Martínez T;García-Arias S;Hernández-Moreno A;Urioste-Fondo A;Cano-Rodríguez I;Ballesteros-Pomar MD;
{Journal}: Endocrinol Diabetes Nutr (Engl Ed)
{Volume}: 67
{Issue}: 1
{Year}: Jan 2020
{Factor}: 1.833
{DOI}: 10.1016/j.endinu.2019.05.006
{Abstract}: <B>BACKGROUND: </B>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).<BR><B>METHODS: </B>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.<BR><B>RESULTS: </B>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.<BR><B>CONCLUSIONS: </B>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.