Annals of Surgery
Protein-sparing therapy after major abdominal surgery

Ann Surg 1996 ; 223 : 357-362

Doglietto GB, Gallitelli L, Pacelli F, Bellantone R, Malerba M, Sgadari A, Crucitti F.

Istituto di Clinica Chirurgica, UCSC, Roma, Italy.

A prospective multicenter randomized trial was designed to evaluate the clinical efficacy of postoperative protein-sparing therapy.

The metabolic effect of postoperative protein-sparing therapy has been shown by several studies, but the clinical utility of this treatment has not been investigated by large prospective trials.

Six hundred seventy-eight patients undergoing major elective abdominal surgery were randomly assigned to receive either protein-sparing therapy after surgery (protein-sparing therapy group) or conventional therapy (control group). The patients were monitored for postoperative complications and mortality.

The rate of major postoperative complications was similar in both groups (protein-sparing therapy group, 19.5%; control group, 20.9%; p=0.66) as were the overall postoperative mortality rates (4.7% and 3.5%, respectively; p=0.43).

The present study indicates that routine protein-sparing therapy for patients normonourished or mildly malnourished undergoing major abdominal surgery is not clinically justified.