Early Postoperative Enteral Versus Parenteral Nutrition In Patients With Gastrointestinal Cancer: A Randomized Controlled Tiral

Purpose: It is statistically that gastrointestinal cancer accounts formore than half of the total incidence of malignancy, while most of thesepatients combined with malnutrition, anemia, immune suppression in thepreoperative, and they can not be feeded by mouth regularly, so thenutrition therapy directly related to the success of the surgery and thepostoperative recovery. At present, the postoperative nutritional approachincludes enteral nutrition (EN) and parenteral nutrition (PN): according tothe type of protein EN can be divided into elements type and the wholeprotein type, their supporting pattern includes oral、jejunum nubrientcanal、jejunum colostomy and so on; PN formulation including: fatemulsion, amino acids, sugars, vitamins, trace elements and mineral ion,the main way is by peripheral or central venous drip slowly. Since thepreviously viewpoint considered the signs of the recovery forgastrointestinal function were anus exhaust and defecation, and inconsideration of the protection for the gastrointestinal tract anastomosis,PN in clinical widely used. But after gastrointestinal cancer, theadvantages for early EN support in addition to the digestive functiondisorders, gradually recognized by scholars at home and abroad. In thistext, we aims to give a randomized controlled study for gastrointestinalcancer patients who underwent surgery in our hospital.Objective: To discuss the influences on nutritional status,postoperative complications, postoperative immune function, and thehospitalization time between enteral nutrition and parenteral nutrition inpatients suffered with gastrointestinal malignant tumors.Method: In our hospital there were92cases who diagnosed gastrointestinal malignant tumor and treated with surgery operationsbetween2010-2012, now we divided them into two groups randomly:50cases of observation group (enteral nutrition group) and42patients ofcontrol group (parenteral nutrition group), we extract venous blood,detect the total number of lymphocyte, T-lymphocyte subsets (CD3+、CD4+、CD8+、CD4+/CD8+) and weight, serum albumin, prealbumin,nutritional status and so on, one day before and3days、7days after theoperation. And compare the the incidence of complications, hospital stay,fever time and other indicators between the two groups.Results:The weights of both observation group and control groupwere decreased, but the level of albumin and prealbumin were higher inthe observation group than the control group; the total number ofLymphocyte、CD3+、CD4+、CD8+,and the ratio of CD4+/CD8+wereall decreased, but the recovery in observation group was higher than thecontrol group. The rates of complications and fever time andhospitalization time were significantly shorter in the observation groupthan the control group.Conclusion: Early enteral nutrition has more advantages thanparenteral nutrition after gastrointestinal malignant tumor surgery, it canreduce the incidence of postoperative complications, shorterhospitalization time, can improve the level of nutrition and immunefunction of patients.