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, 王贵和, 束宽山, 等. 加速康复外科在腹腔镜辅助胃癌根治术中的应用及其对患者术后恢复、营养及应激的影响. 中国普通外科杂志, 2019, 28(10): 1228-1236.
2.	程康文, 王贵和. 加速康复外科对腹腔镜胃癌根治术患者炎症因子与免疫功能的影响. 腹腔镜外科杂志, 2017, 22(1): 30-35.
3.	朱明炜. 围手术期补充性肠外营养支持治疗. 中国实用外科杂志, 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, 陈辉, 李良庆. 添加 ω-3 鱼油脂肪乳的围术期肠外营养支持对老年胃癌患者营养状况、免疫功能及术后并发症的影响. 中国老年学杂志, 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.	单廷, 陈义钢, 洪波, 等. ω-3 鱼油脂肪乳在胃癌根治术后肠外营养支持治疗中的应用价值. 中华消化外科杂志, 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.	刘立刚, 刘务华, 姚鹏飞, 等. ω-3 不饱和脂肪酸乳剂在肠外营养中对胃肠道恶性肿瘤术后短期疗效的meta分析. 中国普外基础与临床杂志, 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.	梁涛, 伍晓汀. ω-3 多不饱和脂肪酸对老年胃癌患者术后谵妄的预防作用. 中国普外基础与临床杂志, 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.	谢显龙, 王琤, 黎阳, 等. ω-3 脂肪酸肠外营养治疗重症肿瘤患者的临床研究. 实用医学杂志, 2017, 33(22): 3745-3748.
23.	吴泊, 王涛, 丁洪亮, 等. 鱼油脂肪乳对全肠外营养大鼠肝功能的影响. 肠外与肠内营养, 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.	李智强, 杨大刚, 王惠群. ω-3 鱼油脂肪乳对肝细胞氧化损伤的修复作用及其机制. 山东医药, 2016, 56(47): 25-28.

1. 程康文, 王贵和, 束宽山, 等. 加速康复外科在腹腔镜辅助胃癌根治术中的应用及其对患者术后恢复、营养及应激的影响. 中国普通外科杂志, 2019, 28(10): 1228-1236.
2. 程康文, 王贵和. 加速康复外科对腹腔镜胃癌根治术患者炎症因子与免疫功能的影响. 腹腔镜外科杂志, 2017, 22(1): 30-35.
3. 朱明炜. 围手术期补充性肠外营养支持治疗. 中国实用外科杂志, 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, 陈辉, 李良庆. 添加 ω-3 鱼油脂肪乳的围术期肠外营养支持对老年胃癌患者营养状况、免疫功能及术后并发症的影响. 中国老年学杂志, 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. 单廷, 陈义钢, 洪波, 等. ω-3 鱼油脂肪乳在胃癌根治术后肠外营养支持治疗中的应用价值. 中华消化外科杂志, 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. 刘立刚, 刘务华, 姚鹏飞, 等. ω-3 不饱和脂肪酸乳剂在肠外营养中对胃肠道恶性肿瘤术后短期疗效的meta分析. 中国普外基础与临床杂志, 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. 梁涛, 伍晓汀. ω-3 多不饱和脂肪酸对老年胃癌患者术后谵妄的预防作用. 中国普外基础与临床杂志, 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. 谢显龙, 王琤, 黎阳, 等. ω-3 脂肪酸肠外营养治疗重症肿瘤患者的临床研究. 实用医学杂志, 2017, 33(22): 3745-3748.
23. 吴泊, 王涛, 丁洪亮, 等. 鱼油脂肪乳对全肠外营养大鼠肝功能的影响. 肠外与肠内营养, 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. 李智强, 杨大刚, 王惠群. ω-3 鱼油脂肪乳对肝细胞氧化损伤的修复作用及其机制. 山东医药, 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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