Comparative evaluation of the efficacy of semi-elemental and polymeric nutritional formulas in combination with serotonin for the correction of nutritional status disorders and gastrointestinal insufficiency in the postoperative period in oncological patients: results of a pilot study

Objective. To improve perioperative outcomes in patients with malignant GIT tumors and pre-existing NI through early use of a semi-elemental therapeutic formula in combination with continuous infusion of serotonin adipinate. Material and methods. This was a prospective, randomized, single-center pilot study including 44 patients aged >65 years after elective GIT surgery for malignant neoplasms with documented NI (≥2 points on NRS-2002) and GII (≥3 points on the LIFE scale). All patients received a low-rate intravenous infusion of serotonin adipinate (20 mg/day) until resolution of GII. Early enteral nutritional support was initiated simultaneously: in the main group, a semi-elemental whey protein hydrolysate-based formula (Peptamen Intense) was used; in the control group, a standard polymeric formula (Nutricomp Intensive) was administered. The severity of GII was assessed using the LIFE scale; plasma serotonin levels, amino acid profile (methionine, arginine, valine, citrulline, etc.), laboratory markers of nutritional status and their dynamics were evaluated on postoperative days 1, 2, and 5. Results. In both groups, serotonin supplementation led to a rapid normalization of initially reduced plasma serotonin levels (from 49.8 ng/mL [19; 71.2] to values within the reference range already by postoperative day 1, with subsequent stabilization). In the main group, the semi-elemental formula provided a more pronounced nutritional effect: by day 5 there was a significant restoration (p