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The role of immunonutrition in gynecologic oncologic surgery.

BACKGROUND
This study assesses the effect of immunonutrition on biochemical and hematological parameters, incidence of infection, postoperative complications, mortality rate and length of hospital stay.


MATERIAL AND METHODS
A total of 50 patients operated on for gynecological malignancies were randomly assigned to two groups, each receiving two days preoperative and seven days postoperative enteral nutrition after intestinal movements started. The patients in group 1 were given 1000 kcal/d immun-enhancing enteral nutrition (IEN). The patients in group 2 received 1000 kcal/d standard enteral nutrition. The nutritional (albumin, prealbumin), immunologic (CRP, white blood cell (WBC) count, lymphocyte population) parameters, length of hospital stay (LOS) and clinical outcomes were examined.


RESULTS
The two groups did not differ in terms of demographic data, nutritional status, surgical status, mortality rate (p > 0.05). WBC count, lymphocyte population, CRP levels were significantly higher in group 1 compared with group 2 in the postoperative period (p < 0.05). Pulmonary and urinary tract infection rates were similar in both groups (p > 0.05) but wound infection, and LOS rate were significantly lower in group 1 than group 2 (p < 0.05).


CONCLUSION
Perioperative immunonutrition proved to be safe and useful in increasing the immunologic response. It may decrease postoperative complications and LOS in patients undergoing surgery for gynecological malignancy.