[PHNUTR-L] l-Alanin-l-glutamine supplementation improves the outcome after colorectal surgery for cancer

[Kathrynne Holden]

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Colorectal Dis. 2007 Jul;9(6):515-20.	
     l-Alanin-l-glutamine supplementation improves the outcome after 
colorectal surgery for cancer.

     Oguz M, Kerem M, Bedirli A, Mentes BB, Sakrak O, Salman B, Bostanci H.

     Department of General Surgery, Medical Faculty, Gazi University, 
Ankara, Turkey.

     Objective To investigate the effect of l-alanine-l-glutamine (Gln) 
on postoperative complication rate and duration of hospitalization in 
patients operated for colorectal cancer. Method A total of 109 patients 
operated with the diagnosis of colorectal cancer and given enteral 
nutrition between January 2001 and January 2005 were prospectively 
analysed. The patients were randomized and analysed in two groups; Gln 
group (n = 57): patients were given parenteral Gln (1 g/kg/day, 
Dipeptiven, Fresenuis Kabi, Germany) together with enteral nutrition 
(Ensure; Abbott, Zwolle, The Netherlands) and the control group (n = 52) 
only received enteral nutrition (Ensure; Abbott), which was a standard 
isonitrogenous and isocaloric formula. The supplemental enteral 
nutrition was provided for at least 5 days pre- and postoperatively 
according to the nutritional status of the patients. Age, gender, 
subjective global assessment (SGA), body mass index (BMI), serum 
albumin, protein, associated disorders, localization of pathology, 
techniques of anastomosis, postoperative complications and length of 
hospital stay were analysed for each patient. Results The duration of 
nutritional support in the Gln group was 6 +/- 2 and 5 +/- 1 days pre- 
and postoperatively; while it was 7 +/- 1 and 6 +/- 1 days for the 
control group, and there were no significant difference among the groups 
(P > 0.05). Age, gender, SGA, BMI, levels of serum albumin and protein, 
localization of pathology and techniques of anastomosis were also 
similar (P > 0.05). Wound infection (P = 0.038), intraabdominal abcess 
formation (P = 0.044) and wound dehiscence (P = 0.044) were 
significantly higher in the control group than in the Gln group. There 
was no significant difference in terms of anastomotic leakage and other 
complications between both groups (P > 0.05). Hospital stay was 
significantly shorter in the Gln group (P < 0.001). Conclusion 
Supplementation of parenteral Gln decreased the postoperative 
complications and hospital stay and in the patients undergoing the 
colorectal surgery for cancer.

     PMID: 17573745 [PubMed - in process]
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Kathrynne Holden, MS, RD < fivestar at nutritionucanlivewith.com >
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