title: [Effect of early enteral nutrition supplemented with glutamine on postoperative intestinal mucosal barrier function in patients with gastric carcinoma].
abstract: OBJECTIVE
  To investigate the effect of early enteral nutrition (EEN) supplemented with glutamine on postoperative intestinal mucosal barrier function of patients with gastric carcinoma.
  
  
  METHODS
  Eighty patients with gastric carcinoma who underwent intraoperative peritoneal hyperthermic chemotherapy(IPHC) were randomized into two groups: EEN+glutamine (EEN+Gln) group(n=40) and EEN group(n=40). Intestinal mucosal barrier function was evaluated by serum diamine oxidase (DAO), ratio of lactulose to mannitol(L/M), endotoxin lipopolysaccharides(LPS), and tumor necrosis factor-α(TNF-α) at 1 day before operation, 1 day, 7 days, 12 days after operation. Time to first flatus and tolerance to EEN were recorded as well.
  
  
  RESULTS
  There were no significant differences in the two groups in demographics(all P>0.05). Two cases(5%) in the EEN+Gln group and 1 case (2.5%) in the EEN group could not tolerate well(P>0.05). On postoperative day 1, there were no differences in serum DAO, L/M ratio, LPS, TNF-α between the two groups (P>0.05). On postoperative day 7, all the parameters for mucosal barrier function were significantly lower in the EEN+Gln group. On postoperative day 12, the urinary L/M and DAO, LPS, and TNF-α were still significantly lower in the EEN+Gln group, however, urinary L/M was comparable between the two groups. There were no differences between the two groups in the time to first flatus (P>0.05).
  
  
  CONCLUSIONS
  The immunologic tolerance of enteral nutrition supplemented with glutamine is favorable, which provides protective effect on intestinal mucosal barrier in patients with gastric carcinoma undergoing IPHC.
authors.affiliation: Department of Gastroenterological Surgery, Zhejiang Provincial People's Hospital, Hangzhou, China.
authors.forename: Xiao-dong
authors.initials: XD
authors.lastname: Xu
authors.forename: Yuan-shui
authors.initials: YS
authors.lastname: Sun
authors.forename: Qin-shu
authors.initials: QS
authors.lastname: Shao
authors.forename: Jun-feng
authors.initials: JF
authors.lastname: Hu
authors.forename: Zhen-yuan
authors.initials: ZY
authors.lastname: Qian
authors.forename: Yong-lie
authors.initials: YL
authors.lastname: Zhou
authors.forename: Zai-yuan
authors.initials: ZY
authors.lastname: Ye
mesh_terms: D000368:Aged; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005973:Glutamine / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000503:physiopathology* / Q000628:therapy
chemical_list: D005973:Glutamine