Z Gastroenterol 2011; 49 - A53
DOI: 10.1055/s-0031-1278484

Effect of immunonutrition on body composition of patients undergoing elective surgery for colorectal cancer

G Lukács 1, T Oláh 1, Z Lelovics 1, L Harsányi 2
  • 1Kaposi Mór Teaching Hospital, Department of General, Vascular and Thoracic Surgery, Kaposvár, Hungary
  • 2Semmelweis University, Faculty of Medicine, 1st Department of Surgery, Budapest, Hungary

Background: Oncological illnesses also go out not widely known neuro-hormonal changes, which can cause changes of body compositions. By the known of body weight, height, age and gender, it is possible to estimate both Extracellular Water (ECW) and Total Body Water (TBW) respectively and by deduction, ICW (Intracellular Water), analyse the changes of body compositions by the use of multi-frequency bioelectrical-impedance analyzer. If the measuring of these data (ECW, ICW) is not possible, the „Illness Marker“ (IM) can be used as a predictive factor.

Methods: A prospective, randomized trial was undertaken at Moritz Kaposi Teaching Hospital (Kaposvár). We aim to investigate the changes of body composition as the result of perioperative immun-enhancing nutritional supplementation in patients undergoing elective surgery for colorectal cancer. 38 patients (25 male, m. age 66.6±9.2yrs) were randomized and receive 7 days both pre- and postoperative immunomodulating enteral diet (2×500ml Impact Enteral®). The Bodystat® QuadScan4000 multi-frequency device was used to measure the Illness Marker and the changes of body composition. T-test was used as the statistical method to compare the data.

Results: The mean of initial weight (74.9±17.1kg) significantly decreased (71.8±16.6kg; p<0.05). The BMI (Body Mass Index) also changed (25.9±5.0 [kg/m2]; 24.8±4.8). Differences were also observed in LBM (Lean Body Mass) (52.5±7.9kg vs. 52.3±13.5kg), ECW 19.0±3.6liter vs. 18.9±3.4liter; ICW 22.0±6.3liter vs. 21.4±5.9liter). Strong significancy (r=0.86; p=0.005) could be found between ECW and IM. The mean IM also decreased (0.89±0.24 vs. 0.91±0.21) that means the general condition of the patients got worse.

Conclusions: By measuring the impedance it is possible to estimate Body Fat, LBM, water spaces (ECW, ICW) or the changes of all. Significancy can be found between the clinical status and both the IM and body composition. According to our results, the IM is a useful marker to establish individual perioperative immun-enhancing nutritional supplementation in patients undergoing elective surgery for colorectal cancer (and probably other oncological patients).