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Patients with peritoneal disease commonly present with symptoms of abdominal distension and subacute intestinal obstruction. This results in poor oral intake leading to these patients often presenting in a malnourished state.
CRS and HIPEC can potential provide improve survival for these patients, however can be a hazardous procedure, involving multi-organ resections. The risk is especially high in poorly nourished patients.
The study investigators hypothesize that perioperative immunonutrition can reduce wound infections and length of hospital stay, and improve perioperative outcomes. To the investigators' knowledge, it has not been evaluated in patients undergoing CRS and HIPEC.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Oral IMPACT | Experimental | Perioperative immunonutrition will commence 5-7 days prior to surgery, and will continue for 5-7 days post-surgery, as soon as the patient is able to consume full feeds as instructed by his/her primary physician. The recommended dose for IMPACT immunotherapy is one packet, to be taken three times a day. |
|
| Standard Nutrition (ENSURE) | Active Comparator | Standard nutritional supplementation will commence 5-7 days prior to surgery, and will continue for 5-7 days post-surgery, as soon as the patient is able to consume full feeds as instructed by his/her primary physician. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| IMPACT immunotherapy | Dietary Supplement | Powdered formula that is pre-packaged in individual packets which the patients will be instructed to mix with water before consumption. |
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| Measure | Description | Time Frame |
|---|---|---|
| Baseline wound infection rates | From date of surgery to date that wound is healed, up to 30 days from surgery |
| Measure | Description | Time Frame |
|---|---|---|
| Peri-operative complications | Within 30 days from surgery | |
| Length of stay | 100 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Melissa Teo, MD | National Cancer Centre, Singapore | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Cancer Centre Singapore | Singapore | 169610 | Singapore |
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The investigators and the clinical team which manages the patient, will be blinded.
| ENSURE | Dietary Supplement | Liquid milk formula available over the counter |
|