The effect of perioperative immunonutrition on the phagocytic activity of blood platelets in advanced gastric cancer patients.

Background and aims: Perioperative immunonutrition can influence the phagocytic activity of platelets in advanced gastric cancer.

Methods: 51 patients with stage IV gastric cancer divided into four groups depending on the clinical status and 40 normal donors were analyzed. Patients of groups I and II underwent palliative gastrectomy. Patients of groups III and IV had exploratory laparotomy. Perioperative immunonutrition was administered as follows: group I--TPN, II--oral arginine, peripheral TPN, III--TPN preoperatively, and IV--without nutrition. The phagocytic activity of blood platelets was determined before and after nutritional therapy and was assessed by measuring the fraction of phagocytic thrombocytes (%phag) and the phagocytic index (Ixphag).

Results: The percentage of phagocytizing platelets and the phagocytic index prior to and after the surgery amounted to the following: group I--1.136-1.237, P = NS, and 1.007-1.1, P = NS, respectively, II--1.111-1.25, P < 0.05, and 1.011-1.083, P < 0.05, III--1.112-1.186, P = NS, and 0.962-1.042, P = NS, and IV--1.085-0.96, P = NS, and 1.023-1.04, P = NS.

Conclusions: The phagocytic activity of platelets in patients with advanced gastric cancer is significantly impaired. Perioperative immunonutrition with oral arginine-rich diet can partially improve the phagocytic activity of blood platelets. This trial is registered with Clinicaltrials.gov--NCT01704664.