Clinical Comparative Study Of Postoperative Early Enteral Nutrition And Total Parenteral Nutrition In Old Esophageal Cancer Patients Undergoing Esophagectomy And Esophageal Replacement With Gastric Tube

Objective: To compare the clinical value of postoperative early enteral nutrition (EEN) with total parenteral nutrition (TPN) in old esophageal cancer patients undergoing esophagectomy and esophageal replacement with gastric tube.Patients and Methods: 45 old patients with middle or lower segment esophageal carcinoma were selected in the thoracic surgery department of Tongji Hospital from January 2010 to October 2010 treated by esophagectomy and esophageal replacement with gastric tube. By different way of nutritional support after operation, these patients were divided into two groups: early enteral nutrition (EEN) group, 24 cases, were managed with early nutritional support through jejunum; total parenteral nutrition (TPN) group, 22 cases, were given nutrition by way of veins. The time for anal exsufflation, defecation and postoperative hospital stay, as well as complications between these two groups were compared. Before surgery, postoperative day 1 and day 7, determinated the value of lymphocytes (LYM), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum albumin (ALB), serum Urea nitrogen (BUN), serum creatinine (SCr).Results:1. Calculated the recovery time for anal exsufflation, defecation and postoperative hospital stay. The results of TPN group were 77.3±14.9 hours, 6.1±0.6 days, and 13.2±1.3 days; and the results of the EEN group were 66.4±7.2 hours, 5.1±0.6 days, and 12.1±0.8 days. The recovery time for anal exsufflation, defecation and postoperative hospital stay in EEN group were shorter than those of TPN group, and the difference was significant.2. Two groups of postoperative day 1, ALT, AST, BUN, SCr indexes increased in varying degrees, but the difference was not significant (P>0.05). In the first day of postoperation, LYM decreased significantly, ALB also significantly reduced; there were no significant difference between two groups. The results of ALT, AST in the 7th day of postoperation between the two groups was not significant. The amount of LYM, ALB in EEN group were higher than in the TPN group; The value of the BUN, SCr in EEN group were lower than in the TPN group; and the difference between the two groups was significant (P <0.05).Conclusions: Compared early postoperative enteral nutrition with total parenteral nutrition in old esophageal cancer patients, the early enteral nutrition is conducive to the recovery of bowel function in patients, to decrease hospitalization time, increase the level of nutrition state and immune function, and the effect on liver and kidney function was little.