[The comparison between early enteral nutrition and total parenteral nutrition after total gastrectomy in patients with gastric cancer: the randomized prospective study].
OBJECTIVE
Early enteral nutrition (EEN) has benefits in reducing infectious complication, length of stay (LOS) and preserving liver function. There are few data about the effect of EEN in the patients who had total gastrectomy. The aim of this randomized and prospective study was to evaluate the effect of EEN after total gastrectomy on nutritional status, liver function, complications and LOS, compared to total parenteral nutrition (TPN) in patients with gastric cancer.


METHODS
Among 56 patients with gastric cancer, 36 and 20 were randomly assigned to EEN and TPN groups, and finally 17 and 16 completed EEN and TPN schedules, respectively. The nutritional parameters, liver function, LOS and abdominal symptoms were compared between 2 groups on pre-operative day and post-operative 7th day.


RESULTS
There was no significant difference in the nutritional parameters, liver function between EEN and TPN groups. Vomiting and abdominal distention were more frequent in EEN than TPN group (2 vs. 0 cases, p=0.485; 1 vs. 0 case, p=1.000, respectively), while increased AST, ALT and total bilirubin were more common in TPN than EEN group (4 vs. 2 cases, p=0.398; 1 vs. 0 case, p=0.485, respectively without statistical significance). LOS was shorter in EEN than TPN group without statistical significance (12 vs. 13 days, p=0.289).


CONCLUSIONS
No significant differences were found in the nutritional status parameters, liver function, complications and LOS between EEN and TPN groups on 7th day after total gastrectomy. Further large scale studies on the advantages and disadvantages of EEN after total gastrectomy are warranted.
Department of Surgery, Yonsei University College of Medicine, 250 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea.
Hye Un
HU
Kim
Jai Bock
JB
Chung
Choong Bai
CB
Kim
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D004750:Enteral Nutrition; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D011446:Prospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*
D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin