Clinical Efficacy of Early Enteral Nutrition on Patients with Gastric Cancer after Radical Operation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 FENGLi ^1,2 ,  WANGFeng ¹ , DONGPei-de ¹ , HAOQin ¹ , SONGWei-dong ²

1. Department of Gastrointestinal Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China;
2. Department of General Surgery, Affiliated People's Hospital of Inner Mongolia Medical University, Hohhot 010020, Inner Mongolia Autonomous Region, China;

Corresponding author：

WANGFeng, Email: wangfeng_nm@126.com

Keywords：

Enteral nutrition; Parenteral nutrition; Gastric cancer; Clinical effect

DOI：

10.7507/1007-9424.20140076

Video：

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Objective To explore the clinical efficacy and security of early enteral nutrition (EN) on patients with gastric cancer after radical operation. Methods Seventy cases who treated in Affiliated Hospital of Inner Mongolia Medical University from Dec. 2008 to Apr. 2013 were randomly divided into EN group (n=35) and parenteral nutrition (PN) group (n=35), analysis and comparison of nutrition indicators and recovery indicators between 2 groups were performed. Results There were no significant differences on levels of count of white blood cell (WBC), serum albumin (ALB), prealbumin (PA), and transferring (TRF) before operation between the 2 groups (P > 0.05). On 3 and 7 days after operation, the levels of ALB, PA, and TRF were all higher in EN group (P < 0.05) besides level of count of WBC. In addition, hospital stay and hospitalization cost were both lower in EN group (P < 0.05), but there was no significant difference on postoperative exhaust time and complication incidence (P > 0.05). Conclusions EN is a safe, effective, and economical method of nutritional supplements, and it is a preferred method of nutritional support for patients with advanced gastric cancer after operation at prophase, which is worthy to apply widely in clinical.

Citation： FENGLi, WANGFeng, DONGPei-de, HAOQin, SONGWei-dong. Clinical Efficacy of Early Enteral Nutrition on Patients with Gastric Cancer after Radical Operation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(3): 325-329. doi: 10.7507/1007-9424.20140076 Copy

1.	Wilmore DW, Kehlet H. Management of patients in fast track surgery[J]. BMJ, 2001, 322(7284):473-476.
2.	黎介寿.胃肠手术的"围手术期营养处理"[J].肠外与肠内营养, 2013, 20(2):65-67.
3.	Karcz W, Głuszek S, Kot M, et al. Influence of nutritional treatment on the postoperative course in patients with gastric cancer[J]. Adv Med Sci, 2006, 51(1):278-282.
4.	李维勤, 李宁.外科病人的代谢改变和围手术期营养支持[J].中国实用外科杂志, 2001, 21(7):442-448.
5.	Gallagher-Allred CR, Voss AC, Finn SC, et al. Malnutrition and clinical outcomes:the case for medical nutrition therapy[J]. J Am Diet Assoc, 1996, 96(4):361-366.
6.	Hermsen JL, Sano Y, Kudsk KA. Food fight!Parenteral nutrition, enteral stimulation and gut-derived mucosal immunity[J]. Langenbecks Arch Surg, 2009, 394(1):17-30.
7.	Mosenthal AC, Xu D, Deitch EA. Elemental and intravenous total parenteral nutrition diet-induced gut barrier failure is intestinal site specific and can be prevented by feeding nonfermentable fiber[J]. Crit Care Med, 2002, 30(2):396-402.
8.	Dervenis C, Smailis D, Hatzitheoklitos E. Bacterial translocation and its prevention in acute pancreatitis[J]. J Hepatobiliary Pancreat Surg, 2003, 10(6):415-418.
9.	Peter JV, Moran JL, Phillips-Hughes J. A meta analysis of treatment outcomes of early enteral versus early parenteral nutrition in hospitalized patients[J]. Crit Care Med, 2005, 33(1):213-220.
10.	Kamei H, Hachisuka T, Nakao M, et al. Quick recovery of serum diamine oxidase activity in patients undergoing total gastr-ectomy by oral enteral nutrition[J]. Am J Surg, 2005, 189(1):38-43.
11.	张秀雄, 罗小军.自制非要素膳在食管、贲门癌术后早期肠内营养中的运用[J].中国现代医药杂志, 2012, 14(1):29-32.
12.	Kehlet H. Fast-track surgery-an update on physiological care principles to enhance recovery[J]. Langenbecks Arch Surg, 2011, 396(5):585-590.
13.	Krenk L, Rasmussen LS, Kehlet H. Delirium in the fast-track surgery setting[J]. Best Pract Res Clin Anaesthesiol, 2012, 26(3):345-353.
14.	江志伟, 黎介寿, 汪志明, 等.加速康复外科用于直肠癌前切除病人价值探讨[J].中国实用外科杂志, 2008, 28(1):59-61.
15.	袁琮韡, 李俊生, 嵇振岭, 等.全肠外营养及早期肠内营养在胃癌全胃切除术后患者中的对比研究[J].中国普外基础与临床杂志, 2010, 17(4):357-361.
16.	Andreyev HJ, Norman AR, Oates J, et al. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies?[J]. Eur J Cancer, 1998, 34(4):503-509.
17.	祝中年.早期胃肠营养改善患者营养状况及预防肠道术后医源性肠饥饿综合征[J].中国普通外科杂志, 2013, 22(4):527-529.
18.	Sedman PC, MacFie J, Palmer MD, et al. Preoperative total parenteral nutrition is not associated with mucosal atrophy or bact-erial translocation in humans[J]. Br J Surg, 1995, 82(12):1663-1667.
19.	李卡, 肖雪玲, 刘爽, 等.胃癌患者术后早期肠内营养的疗效评估[J].中国普外基础与临床杂志, 2013, 20(2):174-177.
20.	Lewis SJ, Egger M, Sylvester PA, et al. Early enteral feeding versus "nil by mouth" after gastrointestinal surgery:systematic review and meta-analysis of controlled trials[J]. BMJ, 2001, 323(7316):773-776.
21.	陈玉民.肠内营养在术后早期的应用[J].中国临床营养杂志, 2003, 11(3):216-218.
22.	宋延强, 吕文平, 庞新建.老年胃癌患者术后早期肠内营养与肠外营养疗效的比较[J].中华普通外科杂志, 2004, 19(2):97-99.
23.	Huang J, Zhou H, Mahavadi S, et al. Signaling pathways medi-ating gastrointestinal smooth muscle contraction and MLC20 phos-phorylation by motilin receptors[J]. Am J Physiol Gastrointest Liver Physiol, 2005, 288(1):G23-G31.
24.	Mazaki T, Ebisawa K. Enteral versus parenteral nutrition after gastrointestinal surgery:a systematic review and meta-analysis of randomized controlled trials in the English literature[J]. J Gastrointest Surg, 2008, 12(4):739-755.
25.	韦京豫.血清转铁蛋白和前白蛋白作为营养参数的比较[J].解放军预防医学杂志, 1988, 6(3):93-94.
26.	魏琳, 武梅, 朱红芳.能全力用于老年卧床患者肠内营养80例临床分析[J].中国药业, 2013, 22(7):81.
27.	蔡青山, 朴文花, 马德强, 等.早期肠内与肠外营养对进展期胃癌术后患者的支持效果[J].宁夏医学杂志, 2010, 32(6):501-503.
28.	荚从正, 张建群, 谭林, 等.食管癌术后早期肠内营养的临床应用[J].安徽医学, 2013, 34(4):426-428.

1. Wilmore DW, Kehlet H. Management of patients in fast track surgery[J]. BMJ, 2001, 322(7284):473-476.
2. 黎介寿.胃肠手术的"围手术期营养处理"[J].肠外与肠内营养, 2013, 20(2):65-67.
3. Karcz W, Głuszek S, Kot M, et al. Influence of nutritional treatment on the postoperative course in patients with gastric cancer[J]. Adv Med Sci, 2006, 51(1):278-282.
4. 李维勤, 李宁.外科病人的代谢改变和围手术期营养支持[J].中国实用外科杂志, 2001, 21(7):442-448.
5. Gallagher-Allred CR, Voss AC, Finn SC, et al. Malnutrition and clinical outcomes:the case for medical nutrition therapy[J]. J Am Diet Assoc, 1996, 96(4):361-366.
6. Hermsen JL, Sano Y, Kudsk KA. Food fight!Parenteral nutrition, enteral stimulation and gut-derived mucosal immunity[J]. Langenbecks Arch Surg, 2009, 394(1):17-30.
7. Mosenthal AC, Xu D, Deitch EA. Elemental and intravenous total parenteral nutrition diet-induced gut barrier failure is intestinal site specific and can be prevented by feeding nonfermentable fiber[J]. Crit Care Med, 2002, 30(2):396-402.
8. Dervenis C, Smailis D, Hatzitheoklitos E. Bacterial translocation and its prevention in acute pancreatitis[J]. J Hepatobiliary Pancreat Surg, 2003, 10(6):415-418.
9. Peter JV, Moran JL, Phillips-Hughes J. A meta analysis of treatment outcomes of early enteral versus early parenteral nutrition in hospitalized patients[J]. Crit Care Med, 2005, 33(1):213-220.
10. Kamei H, Hachisuka T, Nakao M, et al. Quick recovery of serum diamine oxidase activity in patients undergoing total gastr-ectomy by oral enteral nutrition[J]. Am J Surg, 2005, 189(1):38-43.
11. 张秀雄, 罗小军.自制非要素膳在食管、贲门癌术后早期肠内营养中的运用[J].中国现代医药杂志, 2012, 14(1):29-32.
12. Kehlet H. Fast-track surgery-an update on physiological care principles to enhance recovery[J]. Langenbecks Arch Surg, 2011, 396(5):585-590.
13. Krenk L, Rasmussen LS, Kehlet H. Delirium in the fast-track surgery setting[J]. Best Pract Res Clin Anaesthesiol, 2012, 26(3):345-353.
14. 江志伟, 黎介寿, 汪志明, 等.加速康复外科用于直肠癌前切除病人价值探讨[J].中国实用外科杂志, 2008, 28(1):59-61.
15. 袁琮韡, 李俊生, 嵇振岭, 等.全肠外营养及早期肠内营养在胃癌全胃切除术后患者中的对比研究[J].中国普外基础与临床杂志, 2010, 17(4):357-361.
16. Andreyev HJ, Norman AR, Oates J, et al. Why do patients with weight loss have a worse outcome when undergoing chemotherapy for gastrointestinal malignancies?[J]. Eur J Cancer, 1998, 34(4):503-509.
17. 祝中年.早期胃肠营养改善患者营养状况及预防肠道术后医源性肠饥饿综合征[J].中国普通外科杂志, 2013, 22(4):527-529.
18. Sedman PC, MacFie J, Palmer MD, et al. Preoperative total parenteral nutrition is not associated with mucosal atrophy or bact-erial translocation in humans[J]. Br J Surg, 1995, 82(12):1663-1667.
19. 李卡, 肖雪玲, 刘爽, 等.胃癌患者术后早期肠内营养的疗效评估[J].中国普外基础与临床杂志, 2013, 20(2):174-177.
20. Lewis SJ, Egger M, Sylvester PA, et al. Early enteral feeding versus "nil by mouth" after gastrointestinal surgery:systematic review and meta-analysis of controlled trials[J]. BMJ, 2001, 323(7316):773-776.
21. 陈玉民.肠内营养在术后早期的应用[J].中国临床营养杂志, 2003, 11(3):216-218.
22. 宋延强, 吕文平, 庞新建.老年胃癌患者术后早期肠内营养与肠外营养疗效的比较[J].中华普通外科杂志, 2004, 19(2):97-99.
23. Huang J, Zhou H, Mahavadi S, et al. Signaling pathways medi-ating gastrointestinal smooth muscle contraction and MLC20 phos-phorylation by motilin receptors[J]. Am J Physiol Gastrointest Liver Physiol, 2005, 288(1):G23-G31.
24. Mazaki T, Ebisawa K. Enteral versus parenteral nutrition after gastrointestinal surgery:a systematic review and meta-analysis of randomized controlled trials in the English literature[J]. J Gastrointest Surg, 2008, 12(4):739-755.
25. 韦京豫.血清转铁蛋白和前白蛋白作为营养参数的比较[J].解放军预防医学杂志, 1988, 6(3):93-94.
26. 魏琳, 武梅, 朱红芳.能全力用于老年卧床患者肠内营养80例临床分析[J].中国药业, 2013, 22(7):81.
27. 蔡青山, 朴文花, 马德强, 等.早期肠内与肠外营养对进展期胃癌术后患者的支持效果[J].宁夏医学杂志, 2010, 32(6):501-503.
28. 荚从正, 张建群, 谭林, 等.食管癌术后早期肠内营养的临床应用[J].安徽医学, 2013, 34(4):426-428.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Efficacy of Early Enteral Nutrition on Patients with Gastric Cancer after Radical Operation

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