Abstract
OBJECTIVE: A prospective multicenter randomized trial was designed to evaluate the clinical efficacy of postoperative protein-sparing therapy. SUMMARY BACKGROUND DATA: The metabolic effect of postoperative protein-sparing therapy has been shown by several studies, but the clinical utility of this treatment has not been investigated by large prospective trials. METHODS: Six hundred seventy-eight patients undergoing major elective abdominal surgery were randomly assigned to receive either protein-sparing therapy after surgery (protein-sparing therapy group) or conventional therapy (control group). The patients were monitored for postoperative complications and mortality. RESULTS: The rate of major postoperative complications was similar in both groups (protein-sparing therapy group, 19.5%; control group, 20.9%; p=0.66) as were the overall postoperative mortality rates (4.7% and 3.5%, respectively; p=0.43). CONCLUSIONS: The present study indicates that routine protein-sparing therapy for patients normonourished or mildly malnourished undergoing major abdominal surgery is not clinically justified.
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- Bellantone R., Doglietto G. B., Bossola M., Pacelli F., Negro F., Sofo L., Crucitti F. Preoperative parenteral nutrition in the high risk surgical patient. JPEN J Parenter Enteral Nutr. 1988 Mar-Apr;12(2):195–197. doi: 10.1177/0148607188012002195. [DOI] [PubMed] [Google Scholar]
- Buzby G. P., Knox L. S., Crosby L. O., Eisenberg J. M., Haakenson C. M., McNeal G. E., Page C. P., Peterson O. L., Reinhardt G. F., Williford W. O. Study protocol: a randomized clinical trial of total parenteral nutrition in malnourished surgical patients. Am J Clin Nutr. 1988 Feb;47(2 Suppl):366–381. doi: 10.1093/ajcn/47.2.366. [DOI] [PubMed] [Google Scholar]
- Elwyn D. H., Gump F. E., Lles M., Long C. L., Kinney J. M. Protein and energy sparing of glucose added in hypocaloric amounts to peripheral infusions of amino acids. Metabolism. 1978 Mar;27(3):325–331. doi: 10.1016/0026-0495(78)90112-9. [DOI] [PubMed] [Google Scholar]
- Greenberg G. R., Marliss E. B., Anderson G. H., Langer B., Spence W., Tovee E. B., Jeejeebhoy K. N. Protein-sparing therapy in postoperative patients. Effects of added hypocaloric glucose or lipid. N Engl J Med. 1976 Jun 24;294(26):1411–1416. doi: 10.1056/NEJM197606242942601. [DOI] [PubMed] [Google Scholar]
- Löhlein D. Principles and indications of hypocaloric parenteral nutrition. World J Surg. 1986 Feb;10(1):64–71. doi: 10.1007/BF01656091. [DOI] [PubMed] [Google Scholar]