High dose of arginine enhanced enteral nutrition in postsurgical head and neck cancer patients. A randomized clinical trial

D.A. de Luis, O. Izaola, L. Cuellar, M.C. Terroba, T. Martin, R. Aller*

Institute of Endocrinology and Nutrition, Medicine School and Hospital Rio Hortega; *Hospital Clinico, University of Valladolid, Valladolid (Spain)

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• Nutrition

Objective: Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using a higher dose of arginine (20 g per day) could improve nutritional variables.

Materials and Methods: A population of 72 patients with oral and laryngeal cancer was enrolled. At surgery patients were randomly allocated to two groups: a) patients were receiving an enteral diet supplements with arginine and fiber (group I); b) patients were receiving an isocaloric, isonitrogenous enteral formula (group II).

Results: No significant intergroup differences in the trend of the three serum proteins and lymphocytes were detected. Gastrointestinal tolerance (diarrhea) of both formulas was good (7.89% group I and 5.88% group II: ns). The postoperative infections complications were similar in both groups (23.6% group I and 20.6% group II: ns). Fistula was less frequent in enriched nutrition group (5.2% group I and 17.6% group II: p = 0.026). The length of postoperative stay was better 24.3±14 days in the immunonutrition group than 36.1±27 days in the control group (p = 0.036).

Conclusions: Enriched formula improves local wound complications in postoperative head and neck cancer patients and decreases length of stay.

Corresponding Author: Daniel A. de Luis, MD; e-mail: dadluis@yahoo.es

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