Clinical Evaluation Of Early Sequential Enteral Nutrition In Patients After Esophageal Cancer Surgery

Objective Esophageal cancer is a common digestive tract cancer, Surgery is the most effective treatment for esophageal cancer. As a result of dysphagia, consumption of tumor on the body, as well as surgical trauma and stress, malnutrition is prevalent in patients after esophageal cancer surgery. Therefore, reasonable and effective way to provide nutritional support has a positive significance. To evaluate the feasibility,the safety of early sequential enteral nutrition in Patients after Esophageal cancer surgery and compare the clinical value of sequential enteral nutrition(SEN) with total parenteral nutrition(TPN) and enteral nurtrition(EN).Methods Sixty patients with esophageal carcinoma were prospectively randomized into three groups by different way of nutritional support after operation: early enteral nutrition(EEN) group, 20 cases;total parenteral nutrition(TPN) group,20 cases; sequential enteral nutrition(SEN) group,20 cases. There were no significant differences in the results of all of above parameters in three groups before operation.Each group received isocaloric nurtitional formulas on the same postoperative day. Routine parameters,nutritional parameters, systematic inflammatory responses,and immune status in the blood were measured before surgery, postoperative day 3 and day 8. Serum total protein(TP),albumin(Alb),prealbumin(PAB), tansferrin(TRF)and CRP were evaluated. Peripheral lymphocyte subpopulation,and immunoglublin levels were also measured. The time for anal exsufflation, defecation and postoperative hospital stay, as well as complications among these three groups were compared.Results 1.Three groups of postoperative day 3, the nutritional indexes significantly reduced and increased in varying degrees in the 8th day of postoperation. The amount of PA in ESEN group were higher than in the TPN group and EEN group.2. In the 3th day of postoperation the systematic inflammatory indexes increased,but the difference was not significant(P >0.05). In the 8th day of postoperation, CRP and WBC significantly reduced,and the difference among the three groups was significant(P <0.05).3.The immune indexes in the blood decreased significantly in the 3rd day of postoperation and increased in varying degrees in the 8th day of postoperation. The difference among the three groups was significant(P <0.05).4.The incidence of side effects and the complications of the nutrition was mild,especially in the ESEN group.Conclusions 1.Compared to mere EN and PN, ESEN can get better nutrition effects After esophagectomy; 2.Compared to mere EN and PN, ESEN can reduce the systemic inflammatory response in patients,and also help to reduce catabolism after esophagectomy; 3.With suppressed immune function after esophagectomy, ESEN can restore the immune function better; 4.Compared to mere EN and PN, ESEN is more conducive to recover gastrointestinal function and reduce the incidence of complications after esophagectomy; 5.ESEN is a safe, effective, and feasible treatment after esophagectomy.