Wada N, Kurokawa Y, Tanaka K, Miyazaki Y, Makino T, Takahashi T, Wada H, Yamasaki M, Yamasaki M, Nakajima K, Eguchi H, Takiguchi S, Mori M, Doki Y, et al.
Wounds : a compendium of clinical research and practice. Date of publication 2018 Sep 1;volume 30(9):251-256.
1. Wounds. 2018 Sep;30(9):251-256.
Perioperative Nutritional Support With Beta-hydroxy-beta-methylbutyrate,
Arginine, and Glutamine in Surgery for Abdominal Malignancies.
Wada N(1), Kurokawa Y(1), Tanaka K(1), Miyazaki Y(1), Makino T(1), Takahashi
T(1), Wada H(1), Yamasaki M(1), Yamasaki M(1), Nakajima K(1), Eguchi H(1),
Takiguchi S(1), Mori M(1), Doki Y(1).
Author information:
(1)Department of Gastroenterological Surgery, Osaka University Graduate School of
Medicine, Osaka, Japan.
Although beta-hydroxy-beta-methylbutyrate (HMB), arginine (Arg), and glutamine
(Gln) may contribute to wound healing, no prospective studies have investigated
the efficacy of a compound consisting of HMB, Arg, and Gln (HMB/Arg/Gln) for
reducing wound complications following open abdominal surgery.OBJECTIVE: This
study evaluates the usefulness of perioperative nutrition using HMB/Arg/Gln in
patients who were scheduled to undergo open surgery for abdominal malignancies in
a randomized controlled trial.
MATERIALS AND METHODS: Patients scheduled for open surgery for abdominal
malignancies were randomized to receive HMB/Arg/Gln (1.2 g HMB, 7 g L-Arg, and 7
g L-Gln) or placebo (isocaloric juice). The supplements were provided once daily
for 3 days preoperatively and once daily for 7 days postoperatively. The primary
endpoint was the incidence of wound complications. Secondary endpoints included
the incidence of other complications, postoperative duration of hospital stay,
total-body skeletal muscle mass, handgrip strength, and skin water content.
RESULTS: Sixty-one patients were randomly assigned to either the HMB/Arg/Gln (n =
31) or the placebo (n = 30) group. One patient in the HMB/Arg/Gln group was
ineligible because laparoscopic surgery was performed; thus, 60 patients were
analyzed. The incidence of wound complications (20%) was the same in both groups
(P = 1.000). There were no significant differences in the incidence of other
complications, body composition, handgrip strength, or skin water content between
the 2 groups. Serum growth hormone (GH) levels were significantly higher for
patients whose total intake was > 80% of planned volume in the HMB/Arg/Gln group.
CONCLUSIONS: The incidence of wound complications would not be reduced by
perioperative HMB/Arg/Gln administration in patients who underwent open surgery.
The efficacy of HMB/Arg/Gln for increasing serum GH levels needs to be validated
in another large-scale randomized controlled trial.
PMID: 30256751 [Indexed for MEDLINE]
