Effect of Perioperative Supplementation with Arginine and Omega-3 on Postoperative Complications in Patients Undergoing Gastrointestinal Cancer Surgery: A Pilot Open-Label Randomized Controlled Trial.

One-month mortality did not differ significantly between the immunonutrition and standard care groups.

• Patients were randomized to immunonutrition (n=18) or standard care (n=17).
• p = 0.324 for 1-month mortality comparison between groups.
• The trial was conducted at Salah Azaiez Institute as a pilot open-label randomized controlled trial.

Hospital length of stay was identical between groups and did not differ significantly.

• Median hospital length of stay was 7 days in both the immunonutrition and standard care groups.
• p = 0.392 for the intergroup comparison.
• ICU duration also did not differ significantly (median 5 vs. 6 days, p = 0.601).

Postoperative infectious complication rates were comparable between the immunonutrition and standard care groups.

• Urinary tract infection rates were 11.1% in the immunonutrition group vs. 5.9% in the standard care group (p = 0.939).
• Wound infection rates were 11.1% in the immunonutrition group vs. 5.9% in the standard care group (p = 0.581).
• No statistically significant differences were observed for any infectious complication endpoint.

Postoperative inflammatory markers, including C-reactive protein, did not differ significantly between groups.

• Postoperative CRP was 165 mg/L in the immunonutrition group vs. 175 mg/L in the standard care group.
• Intergroup p-value for CRP was 0.798.
• Other inflammatory markers also did not differ significantly between groups.

The immunonutrition intervention consisted of perioperative arginine and omega-3 supplementation administered both before and after surgery.

• The immunonutrition group received three daily capsules of omega-3 and one sachet of Arginine+ per day.
• Supplementation was administered for 7 days preoperatively and 7 days postoperatively.
• The control group received standard care without supplementation.
• 35 adult patients scheduled for elective gastrointestinal cancer surgery were enrolled in total.

The authors concluded that larger, adequately powered multicenter trials with optimized dosing are required to clarify the role of immunonutrition in gastrointestinal oncology.

• The trial was characterized as a pilot study with a small, heterogeneous cohort.
• The authors noted that at the administered dose, immunonutrition did not provide additional benefit beyond standard care.
• The authors called for multicenter trials to address limitations of sample size and dosing.