Omega-3 fatty acids given as part of an oral nutritional supplement may help preserve muscle mass in patients undergoing surgery for esopahageal cancer, a procedure normally associated with significant weight loss.
That’s the finding of research at Trinity College Dublin published in this month’s Annals of Surgery. The researchers chose to study patients undergoing surgery for esophageal cancer as this surgery is one of the most stressful and serious operations a patient can undergo.
Dr. John Reynolds, surgery professor at Trinity and St James’s Hospital and the lead researcher on the study, said: “The surgery is a serious operation lasting several hours and can take weeks to recover from surgery and up to six months to recover pre-illness quality of life. Weight loss is extremely common both before and especially after this type of surgery, and any approach that can preserve weight, in particular muscle weight and strength, may represent a real advance.”
In a double-blind randomized control trial, the gold standard in medical research, patients awaiting esophagectomy surgery were assigned randomly to treatment and control groups. Although both groups received a 240ml nutritional supplement twice daily starting five days before surgery, patients in the treatment group received an enriched formula with omega-3 (2.2 gram EPA/day).
Omega-3 fats are essential fats found naturally in oily fish, with highest concentrations in salmon, herring, mackerel, and sardines.
Immediately following surgery, the supplement was given through a feeding tube for 14 days while patients recovered in the hospital. Once patients could resume oral feeding, they continued drinking the supplement until 21 days after surgery.
Patients given the standard feed, without omega-3, suffered clinically severe weight loss after surgery, losing an average of four pounds of muscle mass, while the omega-3 group patients maintained all aspects of their body composition.
Commenting in an accompanying editorial in the Annals of Surgery Dr. Michael Meguid, surgery professor at State University of New York noted: “This study is a significant step forward because it underscores the message to surgeons of the importance of using omega-3 based nutrition as an adjunct therapy started at least five days before surgery. It should no longer be a surgeon’s preference, but the standard of expected norm for the practice of elective complex gut cancer surgery”.
Reynolds said: “We do not expect these findings are unique to cancer surgery, and similar benefits may accrue to patients needing complex surgical care for non-cancer problems, for instance liver transplantation or major cardiac surgery.”
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