High dose of arginine enhanced enteral nutrition in postsurgical head and neck cancer patients. A randomized clinical trial.

Patients with head and neck cancer undergoing surgery have a high incidence of postoperative complications. The aim of our study was to investigate whether postoperative nutrition of head and neck cancer patients, using a higher dose of arginine (20 g per day) could improve nutritional variables.A population of 72 patients with oral and laryngeal cancer was enrolled. At surgery patients were randomly allocated to two groups: a) patients were receiving an enteral diet supplements with arginine and fiber (group I); b) patients were receiving an isocaloric, isonitrogenous enteral formula (group II).No significant intergroup differences in the trend of the three serum proteins and lymphocytes were detected. Gastrointestinal tolerance (diarrhea) of both formulas was good (7.89% group I and 5.88% group II: ns). The postoperative infections complications were similar in both groups (23.6% group I and 20.6% group II: ns). Fistula was less frequent in enriched nutrition group (5.2% group I and 17.6% group II: p = 0.026). The length of postoperative stay was better 24.3 +/- 14 days in the immunonutrition group than 36.1 +/- 27 days in the control group (p = 0.036).Enriched formula improves local wound complications in postoperative head and neck cancer patients and decreases length of stay.