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The Effects of Immediate Enteral Feeding with a Formula Containing High Levels of ω‐3 Fatty Acids in Patients After Surgery for Esophageal Cancer
Author(s) -
Aiko Satoshi,
Yoshizumi Yutaka,
Tsuwano Shinichi,
Shimanouchi Masaoki,
Sugiura Yoshiaki,
Maehara Tadaaki
Publication year - 2005
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607105029003141
Subject(s) - medicine , polyunsaturated fatty acid , fibrinolysis , esophageal cancer , gastroenterology , coagulation , platelet , parenteral nutrition , enteral administration , thromboxane b2 , anesthesia , surgery , cancer , fatty acid , biochemistry , chemistry
Background: We investigated whether supplementation of enteral nutrition (EN) with ω‐3 polyunsaturated acids (PUFAs) affected platelet aggregation, coagulation activity, and inflammatory response in the early stages after esophageal cancer surgery. Methods: Twenty‐eight patients with esophageal cancer who underwent the same surgical procedure were selected for this study. All patients received EN, which was started immediately after the operation and was increased to a maximum volume of 1500 ml/day by the third postoperative day (POD). Eleven patients received a conventional EN formula (Ensure Liquid), while the remaining 17 patients received a different formula rich in ω‐3 PUFAs (Racol [RAC]). Several markers of coagulation and fibrinolysis were determined in POD 2, while the concentrations of interleukin (IL)‐6, IL‐8, 6‐keto‐PGF1α and thromboxane B2 were determined on PODs 1, 3, and 5. Results: A total of 27 patients completed the study, 11 in the Ensure Liquid group and 16 in the RAC group. Administration of RAC significantly inhibited the postoperative decrease in platelet count. The level of D‐dimer was attenuated significantly in the RAC group. Plasma IL‐8 levels were decreased significantly in the RAC group on PODs 1 and 3. The anti‐inflammatory effects of ω‐3 PUFAs were confirmed by the clinical findings of lower body temperature. The plasma concentration of 6‐keto‐PFG1α also tended to decrease in the RAC group with a significant difference on POD 5. Conclusions: Early EN with a large amount of ω‐3 PUFAs in reduced platelet aggregation, coagulation activity, and cytokine production. All these effects would be expected to be beneficial in patients following esophageal cancer surgery. The clinical significance of the changes in eicosanoid production remains to be established.