[Association of the jejunal mucosal structure and the tolerance of early postoperative enteral nutrition in gastric carcinoma patients at different ages].
OBJECTIVE
To explore the association of the changes of the jejunal mucosal structure and the tolerance of early postoperative enteral nutrition in gastric cancer patients at different ages.


METHODS
Thirty patients of gastric carcinoma undergone total gastrectomy were enrolled in this study, including 16 cases over 65 years old and 14 cases under 40 years old. The specimens of jejunal mucosa were taken during operation and were observed by light and electronic microscopes. The height and width of the jejunal villus and the thickness of the jejunal mucosa were measured. All the patients received enteral nutrition from the second postoperative day to discharge. The complications related to enteral nutrition, such as abdominal pain, abdominal distention, and diarrhea, were observed.


RESULTS
The height of the jejunal villus was longer in young age group than that of old age group. The width of the jejunal villus was shorter in young age group than that of old age group. The thickness of the jejunal mucosa was thinner in old age group than that of young age group. The changes of ultrastructure of the jejunal mucosal epithelial cell in old age group showed that microvilli are rare and disorder, mitochondrial cristaes were broken and dissolved. The young age group was normal in the ultrastructure. The complications related to enteral nutrition were more frequent in old age group than those in young age group, especially in abdominal distention and diarrhea (P<0.01).


CONCLUSIONS
The atrophy of jejunal mucosa in old age patients with gastric carcinoma lead to decrease the tolerance and increase the complications of the postoperative enteral nutrition.
Jie
Zhi-gang
ZG
Department of Gastrointestinal Surgery, The First Affiliated Hospital, Nanchang University, Nanchang 330006, China. jiezg123@126.com
Liao
Xin-fang
XF
Xie
Xiao-ping
XP
Liu
Yi
Y
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004750:Enteral Nutrition; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology* / Q000648:ultrastructure; D007583:Jejunum / Q000473:pathology* / Q000648:ultrastructure; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D013274:Stomach Neoplasms / Q000473:pathology*