Randomized clinical trial of perioperative omega-3 fatty acid supplements in elective colorectal cancer surgery

Sorensen, L.S., Thorlacius-Ussing, O., Schmidt, E.B., Rasmussen, H.H., Lundbye-Christensen, S., Calder, P.C. and Lindorff-Larsen, K. (2014) Randomized clinical trial of perioperative omega-3 fatty acid supplements in elective colorectal cancer surgery. British Journal of Surgery, 101 (2), 33-42. (doi:10.1002/bjs.9361). (PMID:24281905)

Abstract

BACKGROUND: Omega-3 fatty acids (n-3 FAs) may have beneficial clinical effects, and n-3 FA supplements may improve outcome after surgery.

METHODS: In a randomized double-blind placebo-controlled trial in single centre, patients referred for elective colorectal cancer surgery received either an n-3 FA-enriched oral nutritional supplement (ONS) (Supportan®, 200 ml twice daily) providing 2·0 g eicosapentaenoic acid (EPA) and 1·0 g docosahexaenoic acid (DHA) per day, or a standard isocaloric and isonitrogenous ONS, for 7 days before and 7 days after surgery. The primary endpoint was infectious and non-infectious complications within 30 days of surgery. Secondary endpoints were length of hospital stay, intensive care unit admission, readmissions, and concentrations of marine n-3 FAs and arachidonic acid in granulocyte membranes.

RESULTS: Some 148 consecutive patients (68 women, 80 men; mean age 71 (range 41-89) years) were randomized. There was no significant difference between groups in infectious or non-infectious postoperative complications (P = 1·000). Granulocyte levels of EPA, DHA and docosapentaenoic acid (DPA) were significantly higher in the n-3 FA-enriched supplement group compared with the control group (P < 0·001). The arachidonic acid level in granulocytes was significantly lower in the enriched group than in the control group (P < 0·001).

CONCLUSION: EPA, DHA and DPA were incorporated into granulocytes in patients receiving n-3 FAs, but this was not associated with improved postoperative outcomes.

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Contributors

Author: P.C. Calder

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