| Backgroud: Recently, greater attention has focused on enteral nutrition because of the proceeding for the research on bacterial translocation and gut infection. There is a new nutrition theory called ecoimmunonutrition, which has special emphasis on not only 7 nutrients including fiber but also probioticbacteria. Probiotic bacteria have been proven effective in preventing colonisation of the gut by potential pathogens and stimulating the immune system. But there is seldom report about ecoimmunonutrition used perioperatively in patients with gastrointestinal tumor.Objective: To evaluate the feasibility and effect of perioperative enteral nutrition with fiber-containing plus Lactobacilli in gastrointestinal tumor patients.Methods: Prospectively, 45 patients with gastrointestinal tumor were randomly divived into three groups. The three groups were parenteral nutrition group (group PN), perioperatively using enteral nutrition with fiber-containing plus living lactobacilli group(group LEN)and enteral nutrition with fiber-containing group (group FEN). The main parameters observed are body weight, renal and liver functions, plasma protein, Hb, immunoglobulin A, total lymphocyte, endotoxin, CRP, IL-1, IL-6 and TNF. Others including complications, vital signs, resumption of gastrointestinal functions and hospital stay were also recorded.Results: No death and serious complications occurred during the trial in all three groups. There were no statistical differences between groups in body weight loss and Hb levels postoperatively (P>0. 05). Increases of blood glucose and serum CRP level were observed postoperat ively in the three groups (P<0. 05), but both the increment in group PN were of most(P<0. 01). Prealbumin levels maintained stable both in group LEN and FEN postoperat ively, but the prealbumin level decreased significantly in group PN. Serum transferrin and totallymphocyte count maintained stable in group LEN but decreased significantly in other two groups postoperatively. Lactate dehydrogenase (LDH) level maintained stable both in groups LEN and FEN, while increased significantly in group PN postoperatively(P<0. 01). An decreased cholesterol level was observed in groups LEN and FEN, but the changes of cholesterol level in group LEN was moresignificant postoperatively (P<0. 01). White blood cell count maintained stable in group LEN while increased significantly in other two groups postoperatively(P<0. 05). The levels of IgA significantly increased in group LEN but maintained stable in other two groups after nutrition support. Endotoxin levels on postoperative day 3 elevated in the three groups, but the increments both in groups LEN and FEN were significantly lower than PN group (P<0. 05). Moreover, the endotoxin level on postoperative day 6 was lower than that in preoperation in the group LEN, preparing that the endotoxin level on postoperative day 6 was still much higher than that in preoperation in the group PN (P<0. 05). The levels of TNF increased postoperatively in the three groups, and higher increase of TNF level was seen in group PN although there were no statistical differences in the increment among the three groups. Both the cytokines IL-1, ILH3 levels and the blood complememts during the trial were no statistic differences among the three groups. The recovering times of postoperative audible bowel sounds both in groups LEN and FEN were significantly shorter than group PN (P<0. 01).The bowel movement in group LEN significantly recovered earlier than that both in groups FEN and PN (P<0. 05). More clinical significance was that the incidences of infection complications in groups LEN, FEN and PN are 6. 67%, 20% and 46. 67% respectively, and the incidences of infectioncomplications both in group LEN were significantly lower than that in group PN. There were no statistical differences in hospital stay among the three groups.Conclusion: Perioperative enteral nutrition with fiber-containing plus Lactobacillus or only fiber-containing used in gastrointestinal tumor patients were...
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