BACKGROUND: The present rationale appears to prefer early postoperative enteral nutrition to total parenteral nutrition. But no clear conclusions exist for demonstrating the clinical benefit of early postoperative enteral nutrition in patients after the major surgical resections of upper gastrointestinal tract. AIM: To compare the clinical impact of various types of the artificial nutrition by comparison of the postoperative complications. METHODS: Prospective, randomized, controlled clinical trial. Sixty-two patients were analyzed. In the group I (21 patients) the total parenteral nutrition was received, in the group II (20 patients) the standard enteral nutrition was received, in the group III (21 patients) the enteral nutrition enriched with glutamin, arginin and omega-3 fatty acids was received. Both enteral feedings were given early. All three nutritional regiments were isocaloric and isoproteinaceus. RESULTS: The postoperative complications were in 31 patients overall (11, 11, 9 patients in the each group I, II, III). Three patients died in the group I, 2 patients in the group II, and 1 patient in the group III. There were no significance differences (p < 0,05) in postoperative complications, both infectious and non-infectious reasons. CONCLUSION: The study has shown no impact of various type of artificial nutrition on clinical outcome in patients after major resections of upper gastrointestinal tract. There was no significant difference in infectious complications in the groups with enteral feeding. The combination of enteral and parenteral nutrition appears as optimum after major surgery of the upper gastrointestinal tract. It is necessary to realize more extensive studies of homogenous patients to find out the benefit of various types of arteficial nutrition in postoperative period.

• MeSH
• dospělí MeSH
• enterální výživa * MeSH
• gastrointestinální trakt chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• parenterální výživa úplná * MeSH
• pooperační komplikace * MeSH
• pooperační péče MeSH
• potrava speciální * MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• klinické zkoušky MeSH
• randomizované kontrolované studie MeSH
• srovnávací studie MeSH

INTRODUCTION: Perioperative nutritional support in liver surgery remains specific regarding the role of the liver in the metabolism regulation. The loss of functional liver tissue following resection procedures may result in significant metabolic disorders, particularly in patients with preoperative liver impairment in chronic conditions. Perioperative nutritional support is indicated in patients suffering from malnutrition, chronic liver disorders and also following liver resections with limiting residual parenchyma. AIM OF THE STUDY: The retrospective study assessed the effect of complete parenteral nutrition enriched with branched chain amino acids on liver function and the rate of postoperative complications following liver resections (of at least two segments) for colorectal carcinoma metastases. SUBJECTS AND METHODOLOGY: 142 subjects following liver resections for colorectal carcinoma metastases were included in the study. In 42 subjects with anatomical resections of at least two segments, complete parenteral nutrition enriched with branched chain amino acids (3.8 g) was administered postoperatively from Day 1. The parenteral nutrition was maintained for 5 to 7 days, from Day 3, additional oral diet regime was indicated. In 100 subjects with a single segment resections or wedge resections, a combination of glucose 10% and crystalloid solutions was administered from Day 1, and early oral diet was added from Day2. Liver tests were performed during the first postoperative week and protein electrophoresis 14 days postoperatively. RESULTS: During the first postoperative week, the liver test values reached normal values in patients with specialized complete parenteral nutrition. In subjects, where the specialized parenteral nutrition was not administered, increased alcaline phosphatase levels and gamma glutamyl transpherase levels were recorded through the postoperative Day 7. No significant differences were detected in protein electrophoresis values and in rates of postoperative complications (14% in both patient groups). Liver test values in specialized nutritional support patients were negatively affected by the extent of their liver resections and occurrence of additional extra hepatic disorders. Administration of complete parenteral nutrition enriched with branched- chain amino acids proved a positive effect on the liver test values recovery. CONCLUSION: Postoperative parenteral nutrition with solutions enriched with branched-chain amino acids in major liver resections (at least 2 segments) has a positive impact on the liver test values recovery during the early postoperative period.

• MeSH
• hepatektomie * MeSH
• kolorektální nádory patologie   MeSH
• lidé MeSH
• nádory jater sekundární   chirurgie   MeSH
• nutriční podpora * MeSH
• parenterální výživa úplná * MeSH
• pooperační komplikace MeSH
• pooperační péče * MeSH
• větvené aminokyseliny aplikace a dávkování   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• větvené aminokyseliny MeSH

• MeSH
• krevní proteiny analýza   MeSH
• krevní transfuze * MeSH
• lidé středního věku MeSH
• lidé MeSH
• parenterální výživa úplná * MeSH
• pooperační komplikace krev   terapie   MeSH
• sepse krev   terapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• krevní proteiny MeSH

• MeSH
• dietoterapie MeSH
• gastrointestinální motilita * MeSH
• lidé MeSH
• nemoci žaludku etiologie   MeSH
• parenterální výživa MeSH
• pooperační komplikace MeSH
• pooperační péče MeSH
• vagotomie škodlivé účinky   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH