The Effect Of Immunonutrition On The Postoperative Complications In Thymoma With Myasthenia Gravis

Objectives:To test whether preoperative immunonutrition is efcacious in reducing postoperative complications in patients of thymoma with myasthenia gravis(MG).Material:A total of 293 patients operated on for thymoma with myasthenia gravis were prospectively assigned to two groups,each receiving sevenday preoperative and seven-day postoperative nutrition.The patients in immunonutrition group were given oral immunonutrition(IN).Te patients in control group received oral standard nutrition.Immunonutritional and inflammatory biomarkers(Ig A,Ig G,Ig M,CD3 t,CD4t,CD8 t,CD4t/CD8 t ratio,NK-cell,prealbumin,albumin,white blood cells counts,and C-reactive protein)and clinical variables(age,gender,BMI,performance status,type of thymoma,type of MG,operative time,pathology,operative approach,postoperative complications,quantity of drainage,hospital stays)were examined.Result:1.A signifcant reduction in the length of hospital stay,quantity of drainage,and postoperative complications was observed in the IN group(p < 0.05)2.75(26.0%)patients experienced postoperative complications for the entirety,and 22(18.0%)of the 122 patients did in IN group;53(31.0%)of the 171 patients did in SN group(P< 0.05).3.In this study,we found that the incidence of pneumonia and myasthenia gravis crisis was relatively high;with regard to pneumonia,the incidence of pneumonia in the IN group was significantly lower than in the control group(P < 0.05).4.Through the analysis of subgroups with myasthenic crisis the decreased hospital stays,length of extubation,intensive care unit stay,and pneumonia with the IN group were observed significantly.5.On the third postoperative day,the levels of WBC,CRP,and NK-cell dramatically decreased in the IN group(p < 0.05).On the fifth day,in contrast to the significant decrease in the IN group concerning the level of WBC,CRP,and NK-cell,an increase was seen in the level of prealbumin and albumin(p < 0.05).An increase in the level of Ig A,Ig G,Ig M,CD3+T,CD4+T,and CD4+T/CD8+T in the IN group was observed on the seventh day,the same as the value of prealbumin and albumin.The level of WBC,CRP,and NKcell was significantly lower than that in SN group.Conclusion:1.Perioperative nutritional support can reduce the postoperative complications in patients with in patients of thymoma with Myasthenia Gravis.2.Perioperative nutritional support can reduce postoperative quantity of drainage and decrease hospital stays,length ofextubation,intensive care unit stay in patients of thymoma with Myasthenia Gravis.