Impact of early postoperative enteral nutrition on clinical outcomes in patients with gastric cancer

Abstract

The impact of early enteral nutrition (EEN) on clinical outcomes of gastric cancer patients was investigated. Three hundred pa-tients undergoing gastric cancer surgery from July 2010 to May 2014 were randomly divided into experimental and control groups (n = 150/group). Experimental group patients received enteral nutrition in water during the early postoperative period. Control group patients received conventional perioperative treatment. Patients' clinical outcomes, post-operative immune function, and nutritional statuses were compared, which revealed that the postoperative fever duration (80.2 ± 6.0 vs 88.1 ± 8.1 h, P < 0.05), anal exhaust time (78.8 ± 9.3 vs 85.3 ± 8.4 h, P < 0.05), and length of hospitalization (7.73 ± 2.13 vs 9.77 ± 1.76 days, P < 0.01) differed significantly. Treatment costs in thousands of dol-lars were 31.24 ± 3.21 for the experimental group and 35.61 ± 2.32 for the control group; this difference was statistically significant (P < 0.01). The incidence of postoperative complications did not significantly differ between the experimental and control groups [14.0% (21/150) vs 17.3% (26/150), P > 0.05]. At postoperative days 3 and 7, the CD3(+), CD4(+), natural killer cell, albumin, and prealbumin levels and CD4(+)/CD8(+) ra-tio were significantly higher in the experimental group than the control group (all P < 0.05). CD8(+) cell counts were significantly lower in the experimental group than the control group (P < 0.05). Postsurgical oral EEN can improve nutritional status and immune function and promote early recovery of intestinal function in patients with gastric cancer.

Prognostic value of a novel FPR biomarker in patients with surgical stage II and III gastric cancer

“…Palumbo et al reported that lymphatic metastasis, but not primary tumor growth or angiogenesis, was diminished in fibrinogen-deficient mice, suggesting that Fib was a critical determinant of the metastatic potential by impeding elimination of tumor cell by natural killer cell [ 19 , 20 ]. Thirdly, serum Alb was one of the most widely used markers for reflecting nutritional status and hypoproteinmia was reported as a crucial parameter of malnutrition and directly influenced prognosis of GC; low levels of Alb and pAlb levels have an impact on determinant of immune responses and malnutrition, which could impair immune system defending against GC [ 21 , 22 ].…”

Current status of the “enhanced recovery after surgery” program in gastric cancer surgery

“…From outside Japan, we found one RCT and three retrospective studies concerning early diet after gastrectomy published in or after 2014, and two of them focused on total gastrectomy . All four papers mentioned the feasibility and safety of early oral feeding after gastrectomy.…”

Nutritional Care of Gastric Cancer Patients with Clinical Outcomes and Complications: A Review

“…Patients with early enternal nutrition (EEN) showed significantly shorter hospital stay (16.2 [± 3.6]/19.7 [± 4.5] days, p < 0.001) and time until flatus (2.2 [± 0.3]/3.7 [± 0.5] days, p < 0.001 [ 22 ]), whereas no significant differences were found between EEN and total parental nutrition (TPN) [ 23 ]. Compared to traditional perioperative treatment (TP) (e.g., nasoenteral feeding tube and postoperative intravenous infusion), hospital stay (7.73 [± 2.13]/9.77 [± 1.76] days, p = 0.002), time until flatus (78.8 [± 9.3]/85.3 [± 8.4] hours, p = 0.011), and duration of fever (80.2 [± 6.0]/88.1 [± 8.1] hours, p = 0.012) were also shorter in patients with EEN [ 24 ].…”