Effects of parenteral nutrition supplemented with omega-3 fish oil fat emulsion on nutrition, stress, and liver function in patients with gastric cancer after operation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

CHENG Kangwen ¹ ,  WANG Guihe ¹ , SHU Kuanshan ¹ , ZHENG Ming ¹ , WANG Yajuan ¹ , MA Donghua ² , WANG Jian ³

1. Department of Gastrointestinal Surgery, Tongling People’s Hospital, Tongling, Anhui 244000, P. R. China;
2. Nursing Department, Tongling People’s Hospital, Tongling, Anhui 244000, P. R. China;
3. Department of General Surgery, Ninth People’s Hospital Affiliated to Shanghai Jiaotong University, Shanghai 201999, P. R. China;

Corresponding?author：

WANG Guihe, Email: yiyuanckw@163.com

Keywords：

omega-3 fish oil fat emulsion; gastric cancer; parenteral nutrition

DOI：

10.7507/1007-9424.201910110

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Objective To evaluate the value of omega-3 fish oil fat emulsion in parenteral nutrition support after radical resection of gastric cancer patients.Methods The clinical data of 80 patients in Tongling Peopl’s Hospital undergoing radical resection of gastric cancer from March 2018 to September 2019 were enrolled by retrospective method. Of them, 40 patients were treated with routine parenteral nutrition (control group) and 40 patients were treated with extra 100 mL omega-3 fish oil fat emulsion after operation (observation group). Nutritional and stress indicators included blood total albumin (TP), albumin (ALB), c-reactive protein (CRP), and procalcitonin (PCT) on one day before operation, and 1st, 3rd, and 7th day after operation were collected. The collected indexes of liver function included blood cholesterol (CHO), triglyceride (TG), total bilirubin (TBIL), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma glutamyl transpeptidase (γ-GT) on one day before operation, and 3rd and 7th days after operation.Results ① Nutritional indicator. There was no significant differences in TP and ALB levels between the two groups on one day before operation, and on the 1st, 3rd, and 7th day after operation (P>0.05). In the same group compared with one day before operation, the average TP level of the control group and the observation group decreased on the 1st, 3rd, and 7th day after operation (P<0.05), and in the control group and the observation group, the ALB level decreased on the 1st day after operation (P<0.05), and increased on the 7th day after operation (P<0.05). ② Stress index. There was no significant difference in CRP and PCT levels between the two groups on one day before and one day after operation (P>0.05), and the CRP and PCT levels in the observation group were lower than those in the control group on the 3rd day and 7th day after operation (P<0.05). Compared with the CRP and PCT levels on the one day before operation, the average CRP and PCT levels in the observation group and the control group increased on the 1st, 3rd, and 7th day after operation (P<0.05). ③ Liver function index. There was no significant differences in CHO, TG, and γ-GT levels between the two groups on one day before operation and the 3rd day after operation (P>0.05), but the above indexes of observation group were lower on the 7th day after operation than those of the control group (P<0.05). There was no significant differences on TBIL, ALT, and ALP levels between the postoperative observation group and the control group (P>0.05). Compared with one day before operation in the same group, there was no significant difference on CHO and ALP levels on 3rd and 7th day after operation in both the observation group and control group (P>0.05). There was no significant differences in TG and TBIL levels in the observation group on 3rd and 7th day after operation (P>0.05), but the TG and TBIL levels in the control group were increased on 7th after operation (P<0.05), and the ALT and γ-GT levels in the observation group and the control group on 7th day after operation were increased in the same group compared with one day before operation (P<0.05).Conclusion Parenteral nutrition with omega-3 fish oil fat emulsion do not improve the recent postoperative nutritional status, but reduce the inflammatory stress response and protecte liver function in patients with gastric cancer after operation.

Citation： CHENG Kangwen, WANG Guihe, SHU Kuanshan, ZHENG Ming, WANG Yajuan, MA Donghua, WANG Jian. Effects of parenteral nutrition supplemented with omega-3 fish oil fat emulsion on nutrition, stress, and liver function in patients with gastric cancer after operation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(8): 964-969. doi: 10.7507/1007-9424.201910110 Copy

1.	程康文, 王貴和, 束寬山, 等. 加速康復外科在腹腔鏡輔助胃癌根治術中的應用及其對患者術后恢復、營養及應激的影響. 中國普通外科雜志, 2019, 28(10): 1228-1236.
2.	程康文, 王貴和. 加速康復外科對腹腔鏡胃癌根治術患者炎癥因子與免疫功能的影響. 腹腔鏡外科雜志, 2017, 22(1): 30-35.
3.	朱明煒. 圍手術期補充性腸外營養支持治療. 中國實用外科雜志, 2018, 38(3): 266-270.
4.	Mitra A, Ahn J. Liver disease in patients on total parenteral nutrition. Clin Liver Dis, 2017, 21(4): 687-695.
5.	Zhao B, Wang YX, Liu XY, et al. Comparison of effectiveness, safety, and costs of standardized and customized parenteral nutrition support among gastric cancer patients after gastrectomy: a retrospective cohort study. Asia Pac J Clin Nutr, 2018, 27(4): 818-822.
6.	潘敦, 陳輝, 李良慶. 添加 ω-3 魚油脂肪乳的圍術期腸外營養支持對老年胃癌患者營養狀況、免疫功能及術后并發癥的影響. 中國老年學雜志, 2016, 36(19): 4792-4794.
7.	Ma CJ, Wu JM, Tsai HL, et al. Prospective double-blind randomized study on the efficacy and safety of an n-3 fatty acid enriched intravenous fat emulsion in postsurgical gastric and colorectal cancer patients. Nutr J, 2015, 14: 9.
8.	單廷, 陳義鋼, 洪波, 等. ω-3 魚油脂肪乳在胃癌根治術后腸外營養支持治療中的應用價值. 中華消化外科雜志, 2019, 18(10): 960-965.
9.	Gong Y, Liu Z, Liao Y, et al. Effectiveness of ω-3 polyunsaturated fatty acids based lipid emulsions for treatment of patients after hepatectomy: a prospective clinical trial. Nutrients, 2016, 8(6): E357.
10.	劉立剛, 劉務華, 姚鵬飛, 等. ω-3 不飽和脂肪酸乳劑在腸外營養中對胃腸道惡性腫瘤術后短期療效的meta分析. 中國普外基礎與臨床雜志, 2015, 22(11): 1338-1346.
11.	Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual. 8th ed. NewYork: Springer, 2016: 203-220.
12.	Kehlet H. Manipulation of the metabolic response in clinical practice. World J Surg, 2000, 24(6): 690-695.
13.	Calder PC. Very long-chain n-3 fatty acids and human health: fact, fiction and the future. Proc Nutr Soc, 2018, 77(1): 52-72.
14.	Chambrier C, Lauverjat M, Bouletreau P. Structured triglyceride emulsions in parenteral nutrition. Nutr Clin Pract, 2006, 21(4): 342-350.
15.	Lee HJ, Han YM, An JM, et al. Role of omega-3 polyunsaturated fatty acids in preventing gastrointestinal cancers: current status and future perspectives. Expert Rev Anticancer Ther, 2018, 18(12): 1189-1203.
16.	Wei Z, Wang W, Chen J, et al. A prospective, randomized, controlled study of ω-3 fish oil fat emulsion-based parenteral nutrition for patients following surgical resection of gastric tumors. Nutr J, 2014, 13: 25.
17.	Zhao Y, Wang C. Effect of ω-3 polyunsaturated fatty acid-supplemented parenteral nutrition on inflammatory and immune function in postoperative patients with gastrointestinal malignancy: a meta-analysis of randomized control trials in China. Medicine (Baltimore), 2018, 97(16): e0472.
18.	梁濤, 伍曉汀. ω-3 多不飽和脂肪酸對老年胃癌患者術后譫妄的預防作用. 中國普外基礎與臨床雜志, 2019, 26(2): 174-179.
19.	Fang X, Ge K, Song C, et al. Effects of n-3PUFAs on autophagy and inflammation of hypothalamus and body weight in mice. Biochem Biophys Res Commun, 2018, 501(4): 927-932.
20.	Senkal M, Geier B, Hannemann M, et al. Supplementation of omega-3 fatty acids in parenteral nutrition beneficially alters phospholipid fatty acid pattern. JPEN J Parenter Enteral Nutr, 2007, 31(1): 12-19.
21.	Xyda SE, Vuckovic I, Petterson XM, et al. Distinct influence of omega-3 fatty acids on the plasma metabolome of healthy older adults. J Gerontol A Biol Sci Med Sci, 2019, [Epub ahead of print].
22.	謝顯龍, 王琤, 黎陽, 等. ω-3 脂肪酸腸外營養治療重癥腫瘤患者的臨床研究. 實用醫學雜志, 2017, 33(22): 3745-3748.
23.	吳泊, 王濤, 丁洪亮, 等. 魚油脂肪乳對全腸外營養大鼠肝功能的影響. 腸外與腸內營養, 2018, 25(6): 369-373.
24.	Klek S, Chambrier C, Singer P, et al. Four-week parenteral nutrition using a third generation lipid emulsion (SMOFlipid–a double-blind, randomised, multicentre study in adults. Clin Nutr, 2013, 32(2): 224-231.
25.	李智強, 楊大剛, 王惠群. ω-3 魚油脂肪乳對肝細胞氧化損傷的修復作用及其機制. 山東醫藥, 2016, 56(47): 25-28.

1. 程康文, 王貴和, 束寬山, 等. 加速康復外科在腹腔鏡輔助胃癌根治術中的應用及其對患者術后恢復、營養及應激的影響. 中國普通外科雜志, 2019, 28(10): 1228-1236.
2. 程康文, 王貴和. 加速康復外科對腹腔鏡胃癌根治術患者炎癥因子與免疫功能的影響. 腹腔鏡外科雜志, 2017, 22(1): 30-35.
3. 朱明煒. 圍手術期補充性腸外營養支持治療. 中國實用外科雜志, 2018, 38(3): 266-270.
4. Mitra A, Ahn J. Liver disease in patients on total parenteral nutrition. Clin Liver Dis, 2017, 21(4): 687-695.
5. Zhao B, Wang YX, Liu XY, et al. Comparison of effectiveness, safety, and costs of standardized and customized parenteral nutrition support among gastric cancer patients after gastrectomy: a retrospective cohort study. Asia Pac J Clin Nutr, 2018, 27(4): 818-822.
6. 潘敦, 陳輝, 李良慶. 添加 ω-3 魚油脂肪乳的圍術期腸外營養支持對老年胃癌患者營養狀況、免疫功能及術后并發癥的影響. 中國老年學雜志, 2016, 36(19): 4792-4794.
7. Ma CJ, Wu JM, Tsai HL, et al. Prospective double-blind randomized study on the efficacy and safety of an n-3 fatty acid enriched intravenous fat emulsion in postsurgical gastric and colorectal cancer patients. Nutr J, 2015, 14: 9.
8. 單廷, 陳義鋼, 洪波, 等. ω-3 魚油脂肪乳在胃癌根治術后腸外營養支持治療中的應用價值. 中華消化外科雜志, 2019, 18(10): 960-965.
9. Gong Y, Liu Z, Liao Y, et al. Effectiveness of ω-3 polyunsaturated fatty acids based lipid emulsions for treatment of patients after hepatectomy: a prospective clinical trial. Nutrients, 2016, 8(6): E357.
10. 劉立剛, 劉務華, 姚鵬飛, 等. ω-3 不飽和脂肪酸乳劑在腸外營養中對胃腸道惡性腫瘤術后短期療效的meta分析. 中國普外基礎與臨床雜志, 2015, 22(11): 1338-1346.
11. Amin MB, Edge SB, Greene FL, et al. AJCC Cancer Staging Manual. 8th ed. NewYork: Springer, 2016: 203-220.
12. Kehlet H. Manipulation of the metabolic response in clinical practice. World J Surg, 2000, 24(6): 690-695.
13. Calder PC. Very long-chain n-3 fatty acids and human health: fact, fiction and the future. Proc Nutr Soc, 2018, 77(1): 52-72.
14. Chambrier C, Lauverjat M, Bouletreau P. Structured triglyceride emulsions in parenteral nutrition. Nutr Clin Pract, 2006, 21(4): 342-350.
15. Lee HJ, Han YM, An JM, et al. Role of omega-3 polyunsaturated fatty acids in preventing gastrointestinal cancers: current status and future perspectives. Expert Rev Anticancer Ther, 2018, 18(12): 1189-1203.
16. Wei Z, Wang W, Chen J, et al. A prospective, randomized, controlled study of ω-3 fish oil fat emulsion-based parenteral nutrition for patients following surgical resection of gastric tumors. Nutr J, 2014, 13: 25.
17. Zhao Y, Wang C. Effect of ω-3 polyunsaturated fatty acid-supplemented parenteral nutrition on inflammatory and immune function in postoperative patients with gastrointestinal malignancy: a meta-analysis of randomized control trials in China. Medicine (Baltimore), 2018, 97(16): e0472.
18. 梁濤, 伍曉汀. ω-3 多不飽和脂肪酸對老年胃癌患者術后譫妄的預防作用. 中國普外基礎與臨床雜志, 2019, 26(2): 174-179.
19. Fang X, Ge K, Song C, et al. Effects of n-3PUFAs on autophagy and inflammation of hypothalamus and body weight in mice. Biochem Biophys Res Commun, 2018, 501(4): 927-932.
20. Senkal M, Geier B, Hannemann M, et al. Supplementation of omega-3 fatty acids in parenteral nutrition beneficially alters phospholipid fatty acid pattern. JPEN J Parenter Enteral Nutr, 2007, 31(1): 12-19.
21. Xyda SE, Vuckovic I, Petterson XM, et al. Distinct influence of omega-3 fatty acids on the plasma metabolome of healthy older adults. J Gerontol A Biol Sci Med Sci, 2019, [Epub ahead of print].
22. 謝顯龍, 王琤, 黎陽, 等. ω-3 脂肪酸腸外營養治療重癥腫瘤患者的臨床研究. 實用醫學雜志, 2017, 33(22): 3745-3748.
23. 吳泊, 王濤, 丁洪亮, 等. 魚油脂肪乳對全腸外營養大鼠肝功能的影響. 腸外與腸內營養, 2018, 25(6): 369-373.
24. Klek S, Chambrier C, Singer P, et al. Four-week parenteral nutrition using a third generation lipid emulsion (SMOFlipid–a double-blind, randomised, multicentre study in adults. Clin Nutr, 2013, 32(2): 224-231.
25. 李智強, 楊大剛, 王惠群. ω-3 魚油脂肪乳對肝細胞氧化損傷的修復作用及其機制. 山東醫藥, 2016, 56(47): 25-28.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effects of parenteral nutrition supplemented with omega-3 fish oil fat emulsion on nutrition, stress, and liver function in patients with gastric cancer after operation

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