A randomized double-blind clinical trial with two different doses of arginine enhanced enteral nutrition in postsurgical cancer patients

D.A. de Luis, O. Izaola, L. Cuellar, M.C. Terroba, T. Martin, M. Ventosa

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

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• Nutrition

Objectives: 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 an enteral high dose of arginine (20 g per day) vs a medium dose (12.3 g per day) could improve nutritional variables as well as clinical outcome.

Material and Methods: A population of 115 patients with oral and laryngeal cancer was enrolled. At surgery patients were randomly allocated to two groups: group I (58 patients) received an enteral diet supplements with a high dose of arginine (20 g per day) and group II (57 patients) received an isocaloric, isonitrogenous enteral formula with a medium dose of arginine (12.3 g per day).

Results: Gastrointestinal tolerance (diarrhea) of both formulas was good (3.44% group I and 3.51% group II: ns). The postoperative infections complications were similar in both groups (8.6% group I and 12.2% group II: ns). Fistula was less frequent in enriched nutrition group (3.4% group I and 10.5% group II: p=0.006). The length of postoperative stay was similar in both groups (27.2±17.8 days in group I vs 25.7±18.8 days in group II: ns).

Conclusions: Enriched arginine formula improves fistula wound complications in postoperative head and neck cancer patients. Our results suggest that these patients could benefit from a high dose of arginine enhanced enteral formula.

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

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