Gastrointestinal Postoperative Early Enteral Nutrition: Immuno-enhanced Versus Standard Early Enteral Nutrition (ISEEN)
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Purpose
Patients with gastrointestinal(GI) malignancy usually suffer from malnutrition and suppressed immune function, which might be worsened by major elective surgery.Enteral nutrition has been emphasized for patients with GI malignancy during the perioperative period to accelerate bowel function recovery, and improve nitrogen balance and immune response while reducing postoperative complications and hospitalization time.Early enteral nutrition(EEN) can promote the postoperative recovery of GI function and has been considered to have other advantages such as the reduction of medical cost and maintenance of intestinal barrier function. Immunonutrition containing special compounds like omega-3-unsaturated fatty acids has been put forward to modulate the immune response and improve the immune function in patients with cancer, which may have an better effect on the immune system than standard enteral nutrition. However, studies on immuno-enhanced early enteral nutrition after a resectable GI malignancy surgery are scarce.
The aim of this study was to determine whether immuno-enhanced early enteral nutrition(IEEN) is more effective than standard early enteral nutrition(SEEN) on nutritional status, immune function, surgical outcomes,time to adjuvant chemotherapy and days of hospitalization after laparoscopic GI surgery.
| Condition | Intervention | Phase |
|---|---|---|
|
Gastrointestinal Malignant |
Drug: Immuno-enhanced Drug: Standard early enteral nutrition |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Supportive Care |
| Official Title: | Immuno-enhanced Versus Standard Early Enteral Nutrition Use in Gastrointestinal Postoperative Patients |
- Time to tolerate IEEN/SEEN [ Time Frame: 30 days after operation ] [ Designated as safety issue: No ]
- Overall morbidity rate of IEEN/SEEN [ Time Frame: 60 days after operation ] [ Designated as safety issue: Yes ]
- Mortality rate of IEEN/SEEN after operation [ Time Frame: 60 days after operation ] [ Designated as safety issue: Yes ]
- Energy metabolism [ Time Frame: 10 days after operation ] [ Designated as safety issue: No ]
- Time to the first postoperative adjuvant chemotherapy [ Time Frame: 30 days after operation ] [ Designated as safety issue: Yes ]
- Nutritional status in postoperative day1and 7 of IEEN/SEEN [ Time Frame: 7 days after operation ] [ Designated as safety issue: No ]
- Immune function in postoperative day 1 and 7 [ Time Frame: 7 days after operation ] [ Designated as safety issue: No ]
- Postoperative hospital stay length [ Time Frame: 60 days after operation ] [ Designated as safety issue: No ]
- Rehospitalization rate [ Time Frame: 30 days after discharge ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 200 |
| Study Start Date: | February 2013 |
| Estimated Study Completion Date: | March 2014 |
| Estimated Primary Completion Date: | February 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Standard early enteral nutrition
There would be 100 patients in this group
|
Drug: Standard early enteral nutrition
Immediately drip 37°C saline 20 ml/h and exchange to drip 37°C standard enteral nutrition fluid 20 ml/h at postoperative 6 h via jejunostomy tube or nasogastric tube
|
|
Experimental: Immuno-enhanced early enteral nutrition
There would 100 patients in this group
|
Drug: Immuno-enhanced
Immediately drip 37°C saline 20 ml/h and exchange to drip 37°C enteral nutrition fluid concerning omega-3-unsaturated fatty acids 20 ml/h at postoperative 6 h via jejunostomy tube or nasogastric tube
|
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Resectable gastric cancer by laparoscope
- Resectable colorectal cancer laparoscope
- Resectable gastrointestinal interstitialoma by laparoscope
Exclusion Criteria:
- Locally unresectable tumor
- Metastatic tumor
- Preoperative total parenteral or enteral nutrition
- Lack of the patient's consent for the trial participation
- Previous gastrointestinal resection
Contacts and Locations| Contact: Danhua Yao, MD/PhD | 8602580860961 | yaodh87@gmail.com |
| Contact: Yousheng Li, MD/PhD | 8602580860137 | liys@medmail.com.cn |
| China, Jiangsu | |
| Jinling Hospital | Not yet recruiting |
| Nanjing, Jiangsu, China, 210002 | |
| Contact: Danhua Yao, MD/PhD 8602580860037 | |
| Principal Investigator: Danhua Yao | |
| Principal Investigator: | Danhua Yao, MD/PhD | Nanjing University |
More Information
Publications:
| Responsible Party: | Danhua Yao, Senior Resident, Jinling Hospital, China |
| ClinicalTrials.gov Identifier: | NCT01778166 History of Changes |
| Other Study ID Numbers: | ISEEN001, ISEEN |
| Study First Received: | January 25, 2013 |
| Last Updated: | January 30, 2013 |
| Health Authority: | China: Ministry of Health |
Keywords provided by Jinling Hospital, China:
|
Early enteral nutrition Laparoscopic gastrointestinal surgery Immuno-enhanced nutrition |
ClinicalTrials.gov processed this record on May 19, 2013