Comparative Study On Nutritional Support After Minimally Invasive Esophagectomy

BackgroundEsophageal carcinoma is one of the most frequently occurring malignant tumors in the world,ranking 7th in the incidence rate and 6th in the fatality rate of all malignant tumors,posing a serious threat to human health and attracting great attention.China ranks 5th in the incidence of esophageal cancer globally^[1-2].Esophageal tumors lead to long time of poor food intake and reduced food intake,while increased basal metabolism and preoperative neoadjuvant chemoradiotherapy in tumor patients can lead to preoperative and postoperative malnutrition in patients with esophageal cancer^[3].Surgical treatment is the first choice for patients with esophageal cancer,with major surgical trauma and intraoperative digestive tract reconstruction.Postoperative nutritional status directly affects the condition recovery,anastomotic healing and quality of life.Therefore,perioperative nutrition is very important,and some patients need nutritional support for weeks or even months^[4-8].Therefore,nutrition treatment strategy is particularly important.ObjectiveTo explore and study the enteral and parenteral nutrition modes after laparoscopic thoracic resection combined with radical esophagectomy,and to evaluate the nutritional status,adverse reactions and complications of early enteral nutrition+assisted parenteral nutrition and total parenteral nutrition.MethodsAnalysis of patients with esophageal malignancies treated in the Department of Thoracic Surgery of Anyang People’s Hospital from May 2018 to May 2020.According to strict acceptance criteria,100 patients with thoracic laparoscopy combined with radical esophageal cancer surgery were finally included and divided into early intestine Internal nutrition support+auxiliary parenteral nutrition（experimental group）55 people and total parenteral nutrition（control group）45 people.The experimental group received early enteral nutrition combined with auxiliary parenteral nutrition,and the control group received total parenteral nutrition;after the treatment,the total protein,albumin,prealbumin,total bilirubin,and direct bilirubin were compared before and after the treatment.Alanine aminotransferase,aspartate aminotransferase,C-reactive protein,anal exhaust time,hospitalization days,total hospitalization expenses,lung infection,anastomotic leakage.Results1.Nutrition-related indicators:Total protein（t=2.81,P<0.05）and albumin（t=13.22,P<0.05）of the experimental group were better than those of the control group on the 8th day after surgery.2.Indexes related to liver function:Al ANINE aminotransferase（t=4.01,P<0.05）and aspartate aminotransferase（t=2.70,P<0.05）in the experimental group were better than those in the control group on the third day after surgery.3.Indexes related to liver function:Total bilirubin（t=2.93,P<0.05）,direct bilirubin（t=2.84,P<0.05）,alanine aminotransferase（t=4.46,P<0.05）and aspartate aminotransferase（t=2.50,P<0.05）of the experimental group were better than those of the control group on the 8th day after surgery.4.Inflammation-related indicators:The c-reactive protein（t=3.00,P<0.05）and c-reactive protein（t=4.02,P<0.05）of the experimental group were superior to the control group on the third day after surgery.5.Comparison of hospitalization:The experimental group was better than the control group（2.77±0.44）（t=2.81,P<0.05）in terms of anal exhaust time（1.83±0.31）days,total hospitalization cost（4.65±0.50）yuan than the control group（4.90±0.48）（4.90±0.48）（t=2.41,P<0.05）,and pulmonary infection（7 cases）was better than the control group（13 cases）（X²=3.86,P<0.05）.ConclusionThe model of early enteral nutrition+assisted parenteral nutrition after minimally invasive radical resection of esophageal carcinoma is superior to total parenteral nutrition.