Treatment with growth hormone, somatostatin, and insulin in combination with hypocaloric parenteral nutrition in gastrointestinal cancer patients after surgery |
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Authors: | Quanyan Liu Zhisu Liu Hongliu Chen Lu Ma Li Liu Jun Zhang Yueming He Jiwei Chen Qun Qian |
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Affiliation: | a Department of General Surgery, Research Center of Digestive Diseases, Zhong-Nan Hospital, Wuhan University, Wuhan, People’s Republic of China b Department of General Surgery, Affiliated Hospital of Hubei Institute for Nationalities, Enshi City, People’s Republic of China c Department of Epidemiology and Hygienic Statistics, School of Public Health, Wuhan University, Wuhan, People’s Republic of China |
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Abstract: | ObjectiveThe metabolic response to gastrointestinal cancer in patients undergoing surgery is associated with hypermetabolism and insulin resistance. The potential use of synergetic anabolic hormones in conjunction with hypocaloric parenteral nutrition (HPN) has become a significant area of investigation. The presented study was performed to determine the clinical efficiency and safety of hormone therapy combined with HPN in patients with gastrointestinal cancer.MethodsOne hundred patients with a Nutrition Risk Screening score of 3 or 4 undergoing surgery for gastrointestinal cancer were randomized into two groups. The patients in the control group received standard total parenteral nutrition and systemic insulin. The patients in the study group received HPN and systemic insulin in addition to pretreatment with recombinant human growth hormone and octreotide. Clinical efficiency and safety were evaluated by the measurement of hormones and protein metabolites, immune function, clinical outcome, and adverse events. Follow-ups were performed to determine the influence on prognosis.ResultsTreatment with recombinant human growth hormone, octreotide, and insulin in combination with HPN significantly increased protein synthesis, immune function, and metabolic tolerance, decreased infectious complications, and shortened postoperative hospital stays, but did not increase the risk of tumor development and recurrence in the study group compared with the control group.ConclusionThe proper short-term perioperative administration of growth hormone, somatostatin, and insulin in combination with HPN can overcome the postoperative stress response through the increase of protein synthesis to improve immune function in patients with gastrointestinal cancer after surgery. |
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Keywords: | Growth hormone Somatostatin Insulin Hypocaloric parenteral nutrition Gastrointestinal cancer |
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