Effect of a Perioperative Nutritional Supplementation with Oral Impact® in Patients undergoing Hepatic Surgery for Liver Cancer: A Prospective, Placebo-Controlled, Randomized, Double-Blind Study

Philippe Seguin (1, 2) , Clara Locher (2, 3) , Karim Boudjema (1, 4) , Catherine Hamon (2) , Catherine Mouchel (5, 3) , Yannick Mallédant (1, 2) , Eric Bellissant (6, 3)

1 Foie, métabolismes et cancer
2 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
3 CIC - Centre d'Investigation Clinique [Rennes]
4 Service de Chirurgie Hépatobiliaire et Digestive [Rennes] = Hepatobiliary and Digestive Surgery [Rennes]
5 CIC-P 0203 INSERM - Unité d’Investigation Neurologique [CHU Rennes]
6 Department of clinical and biological pharmacology and pharmacovigilance

Perioperative nutrition with supplements containing l-arginine, ω3-polyunsaturated fatty acids, and nucleotides could boost liver function recovery, immune response, and resistance to infection after hepatic resection. We conducted a placebo-controlled, randomized, double-blind study to assess the effect of a perioperative nutritional supplementation with Oral Impact® in patients undergoing hepatic surgery for liver cancer. Treatment was given three times daily for 7 days before and 3 days after surgery. Primary outcome was factor V, 3 days after surgery. Thirty-five patients (placebo: 17; Oral Impact: 18) were included. Five patients (placebo: three; Oral Impact: two) were not operated and five (placebo: two; Oral Impact: three) did not undergo hepatic resection. Factor V (mean ± SD) was 70 ± 27% and 79 ± 25% (P = 0.409) 3 days after surgery and 90 ± 30% and 106 ± 16% (P = 0.066) 5 days after surgery, in placebo and Oral Impact groups, respectively. There were no significant differences between groups on other outcomes assessing liver function recovery (bile production, γ-glutamyl transferase, α-fetoprotein), immune response (CD3, CD4, CD8 cells, CD4/CD8 ratio, natural killer cells, B lymphocytes), number of infections, and tolerance. A 10-day perioperative nutritional supplementation with Oral Impact does not improve hepatic function, immune response, and resistance to infection in patients undergoing hepatic surgery for liver cancer.

Mots clés: liver cancer; nutrition; Oral Impact®

Domaines: Sciences du Vivant [q-bio]

Philippe Seguin, Clara Locher, Karim Boudjema, Catherine Hamon, Catherine Mouchel, et al.. Effect of a Perioperative Nutritional Supplementation with Oral Impact® in Patients undergoing Hepatic Surgery for Liver Cancer: A Prospective, Placebo-Controlled, Randomized, Double-Blind Study. Nutrition and Cancer, 2016, 68 (3), pp.464-472. ⟨10.1080/01635581.2016.1153670⟩. ⟨hal-01295673⟩