Effect of early enteral nutrition on immune response and clinical outcomes after esophageal cancer surgery
10.3760/cma.j.issn.1671-0274.2014.04.014
- VernacularTitle:早期肠内营养对食管癌患者术后免疫功能和临床结局的影响
- Author:
Guibin ZHAO
1
;
Shouqiang CAO
;
Kai ZHANG
;
Yanzhong XIN
;
Jingquan HAN
;
Qing DONG
;
Jian CUI
Author Information
1. 150001,哈尔滨医科大学附属第四医院胸外科
- Keywords:
Esophageal neoplasms;
Early enteral nutrition;
Parenteral nutrition;
Immune function;
Nutritional status
- From:
Chinese Journal of Gastrointestinal Surgery
2014;(4):356-360
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of early enteral nutrition (EEN) on immune response and clinical outcomes after esophageal cancer operation. Methods Sixty patients with esophageal cancer undergoing radical operation between March 2010 and July 2011 were randomly divided into two groups using envelope method: EEN group (n=30, administration of water and enteral nutrition early after operation) and TPN group (n=30, administration of total parenteral nutrition). Two groups both received 7-day nutrition support. Immune indexes (CD3+, CD4+, CD8+, CD4+/CD8+) and serum nutritional indexes (albumin, pre-albumin, transferrin) were measured before operation and 1-, 3-, and 7-day after operation. The time to first flatus, length of postoperative hospital stay, total hospitalization cost, and postoperative complication were recorded. Results As compared to TPN group, the time to first flatus was significantly shorter in EEN group [(66.5±7.3) h vs. (75.1±6.8) h, P<0.01], as was hospital stay[(7.8±1.1) d vs. (9.3±1.3) d, P<0.01]. Total hospitalization cost[(36 210± 3810) yuan vs. (39 731 ±4013) yuan, P<0.01] was lower in EEN group as compared to TPN group. There was no significant difference in postoperative complication rate between the two groups [13.3%(3/30) vs. 20.0%(6/30),P>0.05]. The levels of CD3+, CD4+, CD4+/CD8+, albumin, prealbumin and transferrin were significantly higher in EEN group as compared to TPN group on postoperative day 3 and 7 (all P<0.05), while CD8+ was significantly lower in EEN group (P<0.05). Conclusion EEN can promote early recovery of gastrointestinal function, improve nutritional and immune function, and therefore lead to fast postoperative recovery in esophageal cancer patients.
