The Application And Study Of Different Nutritional Supports After Radical Gastrectomy For Gastric Cancer

Objective This part of study aims to explore how to choose different types of nutritional support after radical gastrectomy by comparing the clinical effects of the enteral nutrition group(including the jejunostomy nutrition group and the nasojejunal nutrition tube group)and the parenteral nutrition group.Method A total of 265 patients undergoing the radical operation of laparoscopic gastrectomy for gastric cancer at Department of Gastrointestinal Surgery,our Hospital from January 2015 to November 2017 are studies in the retrospective study.According to the presence or absence of enteral nutrition and types of enteral nutrition,these 265 cases are divided into three groups.They are the jejunostomy feeding tube group,the nasojejunal feeding tube group and the parenteral nutrition group.There are 68 cases in the jejunostomy feeding tube group,86 cases in the nasojejunal feeding tube group,and 111 cases in the parenteral nutrition group.This study presents advantages and disadvantages of enteral nutrition and parenteral nutrition by analyzing and comparing the differences in the recovery of intestinal function,the duration of hospital stay,the condition of nutrition and immunity,the expenses on nutritional support and the complications after the operation among these three groups.ResultsThere is no significant difference among three groups in terms of gender,age,tumor stage,weight,and other general data(P>0.05).In terms of the recovery of intestinal function,there is a significant difference in postoperative anus exhaust time between the enteral nutrition group(including the jejunostomy feeding tube group and the nasojejunal feeding tube group)and the parenteral nutrition group(P<0.05).There is no significant difference in the duration of hospital stay between the enteral nutrition group(including the jejunostomy feeding tube group and the nasojejunal feeding tube group)and the parenteral nutrition group(P>0.05).In the case of the expenses on nutritional support,there is a significant difference between the enteral nutrition group(including the jejunostomy feeding tube group and the nasojejunal feeding tube group)and the parenteral nutrition group(P<0.05).With regard to the condition of nutrition and immunity,there is no significant difference in the indexes of pre-operation and the 1st day after operation between the enteral nutrition group(including the jejunostomy tube group and the nasojejunal tube group)and the parenteral nutrition group(P>0.05).However,on the 7th day after operation,there is a significant difference in the indexes of immunity between the enteral and the parenteral nutrition group(P<0.05).With respect to the incidence of postoperative complications,the incidence of the infection of surgical incision in the enteral nutrition group(including the jejunostomy feeding tube group and the nasojejunal feeding tube group)is lower than that in the parenteral nutrition group.Conclusion When supporting nutrition after radical gastrectomy,enteral nutrition is obviously superior to parenteral nutrition in terms of the effect of nutritional support,the case of the expenses on nutritional support,the recovery of immunity and intestinal function,reducing the incidence of postoperative complications and some other aspects.Objective This part of study aims to explore how to choose different types of enteral nutrition after radical gastrectomy by comparing the clinical effects of the jejunostomy feeding tube and the nasojejunal feeding tube.Method A total of 154 patients undergoing the radical operation of laparoscopic gastrectomy for gastric cancer and enteral nutrition after operation at Department of Gastrointestinal Surgery,our hospital from January 2015 to November 2017 are studied in the retrospective study.According to the types of enteral nutrition,these 154 cases are divided into two groups.They are the jejunostomy feeding tube group and the nasojejunal feeding tube group.There are 68 cases in the jejunostomy feeding tube group and 86 cases in the nasojejunal feeding tube group.This part presents advantages and disadvantages of jejunostomy feeding tube and nasojejunal feeding tube by analyzing and comparing the differences between two groups in the recovery of intestinal function,the duration of hospital stay,the condition of nutrition and immunity,the expenses on nutritional support,the duration of operation,the patient experience and the complications after the operation.Results There is no significant difference between groups in terms of gender,age,tumor stage,weight,and other general data.In terms of the recovery of intestinal function,the expenses on nutritional support and the condition of nutrition and immunity(P>0.05).However,in terms of the duration of operation,there is a significant difference between the jejunostomy feeding tube group and the nasojejunal feeding tube group(P<0.05).Regarding postoperative complications,there are significant differences between the jejunostomy feeding tube group and the nasojejunal feeding tube group in pulmonary infection,nausea,emesis,laryngopharyngeal mucosal injury,pharyngeal pain and migration of the feeding tube(P<0.05),while there is no significant difference between two groups in intra-abdominal infection,anastomotic leakage,surgical site infection,abdominal pain,bloating,blockage of feeding tube.Conclusion There is no significant difference in the effect of nutritional support,the case of the expenses on nutritional support and the recovery of immunity and intestinal function between jejunostomy feeding tube and nasojejunal feeding tube.Though the application of the jejunostomy feeding tube will lengthen the duration of operation time,it has more obvious advantages in postoperative complications,patient experience and the the duration of intubation,especially when patients are required a long-term fasting because of postoperative complications after radical gastrectomy.Therefore,the jejunostomy feeding tube is clinically recommended as a type of enteral nutrition.