Clinical And Immunological Effect Of EEIN On The Postoperative Course In Surgery Of Gastric Cancer

BackgroundOn the account of coexisting factors including catabolic biology of the disease,GI disorders,chronic blood loss,and stress-related anorexia,GI cancer patients are at high risk for malnutrition and cachexia.Surgery is the most effective treatment,however,it progressively aggravates the malnutrition condition,as a result of stress response,increased catabolism,and significantly weakened immune function.What is worse,malnutrition and cachexia are also the major causes of cancer patients' death.Thus,the outcome of GI cancer is greatly impacted by nutritional status.Studies have clearly showed that the higher incidences of complications and inferior survival were associated with malnutrition in major abdominal surgery.There is no doubt that nutrition support after surgery has much influence to improve the nutrition condition.Nutrition support is comprised of parenteral nutrition(PN)and enteral nutrition(EN).But when,what and how to feed still bother clinical doctors a lot.AimsWe compared the effects of total parenteral nutrition(TPN)and early enteral immunonutrition(EEIN)on the postoperative nutritional condition,immune status,inflammation level and long-term survival life quality of gastric cancer patients post operation.MethodsSeventy patients were randomly divided into TPN group(n = 35)and EEIN group(n = 35).After 8-day-nutritional treatment,clinical and immunological parameters were evaluated.ResultsEEIN group had significantly shorter hospital stay and higher BMI level on the30 th post-operative day(POD30)than those in TPN group(P < 0.05).However,incidences of short-term post-operative complications had no significant difference(P> 0.05)levels.The percentage of CD4?,natural killer(NK),natural killer T(NK-T)lymphocytes cells in peripheral blood were significantly increased.Compared with TPN group,EEIN group has higher expression of activated cell surface markers such as CD27 and CD28.In addition,the level of inflammatory factor lower in the EEIN group.Progressive-free survival(PFS)and Complications-free survival(CFS)in EEIN group were longer than those in TPN group,and the latter has significant difference(P = 0.036).ConclusionEEIN is obviously superior to TPN in improving nutritional status,enhancing immune functions and elevating quality of life.