Quick recovery of serum diamine oxidase activity in patients undergoing total gastrectomy by oral enteral nutrition.
BACKGROUND
Total parental nutrition (TPN) meets the metabolic needs of postoperative patients, but introduces potential complications, including intestinal mucosal atrophy. Surgical advances have increased the certainty of esophagoenteric anastomosis making early oral enteral feeding after surgery feasible. The objective of the current report is to compare the benefits of enteral nutrition (EN) and TPN in patients undergoing total gastrectomy for gastric cancer.


METHODS
Forty-two patients who underwent total gastrectomy for gastric cancer were randomized to receive oral EN beginning on postoperative day (POD) 3 with peripheral supplements or TPN beginning on POD 3. Serum concentrations of albumin and retinol-binding protein (RBP) as nutritional parameters and diamine oxidase (DAO) activity, an enzyme reflecting mucosal integrity, were measured preoperatively and 1, 4, 7, and 14 days postoperatively and compared between the 2 groups. Complications, abdominal symptoms, duration of hospital stay, and treatment cost per hospitalization were also compared.


RESULTS
Albumin and RBP concentrations changed little in either group. DAO activity decreased in both groups and recovered within 1 week in the EN group but not in the TPN group. Complications were similar in the 2 groups. Treatment cost was less and length of hospital stay was shorter in the EN group.


CONCLUSIONS
EN is an efficient way to provide nutrition to patients and possibly prevent intestinal atrophy in the patient who must endure prolonged postoperative fasting. Compared to TPN, EN reduces treatment cost and hospital length-of-stay.
Kamei
Hideya
H
Department of General Surgery, Yokkaichi Municipal Hospital, 2-2-37 Shibata, Mie-ken 510-8567, Yokkaichi, Japan.
Hachisuka
Takehiro
T
Nakao
Makoto
M
Takagi
Kenji
K
D000328:Adult; D000368:Aged; D006631:Amine Oxidase (Copper-Containing) / Q000097:blood*; D004750:Enteral Nutrition / Q000191:economics; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012177:Retinol-Binding Proteins / Q000032:analysis
D012177:Retinol-Binding Proteins; D006631:Amine Oxidase (Copper-Containing)