Early enteral nutrition and total parenteral nutrition on the nutritional status and blood glucose in patients with gastric cancer complicated with diabetes mellitus after radical gastrectomy

Abstract

Effects of early enteral nutrition (EEN) or total parenteral nutrition (TPN) support on nutritional status and blood glucose in patients with gastric cancer complicated with diabetes mellitus after radical gastrectomy were investigated. One hundred and twenty-nine patients with gastric cancer complicated with diabetes mellitus type 2 admitted to the First People's Hospital of Jinan (Jinan, China), from June 2012 to June 2016 were selected into the study. According to different nutrition support pathways, these patients were randomly divided into the EEN group and the TPN group. The improvement of nutritional indexes, postoperative complications, gastrointestinal function recovery and perioperative blood glucose fluctuation were compared between the two groups. On the 4th day after operation, the improvement levels of total bilirubin (TBL), alanine aminotransferase (ALT), aspartate transaminase (AST), total protein (TP), prealbumin (PAB), hemoglobin (HGB) and weight (Wt) in the EEN group were significantly higher than those in the conventional group (P<0.05). There were no significant differences between the two groups on the 8th day after operation (P>0.05). No patients had complications in the EEN group, while a total of 29 patients in the TPN group suffered adverse reactions, indicating that the incidence rate of complications in the EEN group was significantly lower than that in the TPN group (P<0.05). The postoperative evacuation time was earlier, hospitalization time was shorter and cost of postoperative hospitalization was less in the EEN group than those in the TPN group, and the differences were statistically significant (P<0.05). The blood glucose fluctuation values at fasting and 2 h after a meal in the TPN group were higher than those in the EEN group within 8 days after operation, and the differences were statistically significant (χ2=13.219, P=0.002; χ2=20.527, P<0.001). EEN support provides nutrition for patients with gastric cancer complicated with diabetes mellitus after radical gastrectomy, which is worthy of clinical promotion as it maintains good nutritional status, produces few postoperative complications and keeps the blood glucose level stable, by which the postoperative evacuation time is early, the hospitalization time is short and the cost is low.

Prognostic Significance of C-reactive Protein-to-prealbumin Ratio in Patients with Esophageal Cancer

“…[18][19][20][21] Prealbumin is also associated with postoperative recovery and is an independent predictor of prognosis in patients with malignancies. 22,23 Recently, the preoperative CRP/prealbumin ratio (CRP/PAlb ratio) was reported to have a better predictive value for the recurrence of gastric cancer than traditional inflammatory indices. 24 However, the prognostic significance of CRP/PAlb ratio in esophageal cancer is unclear.…”

Short-term evaluation of immune levels and nutritional values of EN versus PN in gastric cancer: a systematic review and a meta-analysis

“…This meta-analysis included 14 studies comparing EN and PN in gastric cancer resections. There were 10 papers from China, 3 papers from Japan, and 1 paper from Korea: Li et al [36], Wang et al [37], Li et al [38], Chen et al [1], Liu et al [39], Li et al [40], Gao [41], Hongyi et al [42], Chen [43], Li et al [44], Nomura et al [45], Akashi et al [46], Kamei et al [47], and Kim et al [48] . Nine papers were randomized with n = 1437 participants, and 5 papers were retrospective studies with n = 421 participants.…”

“…Three studies presented data on prealbumin [36, 37, 40]. There were 416 and 413 participants in the EN and PN groups, respectively.…”

CRP/prealbumin, a novel inflammatory index for predicting recurrence after radical resection in gastric cancer patients: post hoc analysis of a randomized phase III trial

“…Studies have shown that prealbumin can be used as a parameter of nutritional status evaluation [7] and is superior to albumin (ALB) [8]. What's more, prealbumin is also associated with postoperative recovery [9,10] and is an independent predictor of prognosis in patients with malignancies [11][12][13][14]. However, the sample size of the previous studies was small, and they did not explore whether prealbumin was associated with postoperative recurrence after radical gastrectomy.…”