[Perioperative nutrition support for esophageal cancer complicated with diabetes mellitus].
OBJECTIVE
To compare the efficacy between perioperative enteral and parenteral nutrition support for esophageal cancer patients complicated with diabetes mellitus.


METHODS
Thirty esophageal cancer patients complicated with diabetes mellitus between September and November 2012 were prospectively enrolled in this trial. According to random number table, 30 cases were randomly divided into enteral group (n=15) and parenteral group (n=15). During the period between 3 days before operation and 8 days after operation, patients received enteral nutrition (AnSure) and parenteral nutrition support respectively. The daily dynamic monitoring of blood glucose was performed. Nutritional indexes (albumin and prealbumin) were evaluated 1-day before operation and 8-day after operation. Postoperative recovery time of gastrointestinal function and complications associated with nutritional support were observed. The cost of nutritional support was calculated.


RESULTS
Patients in the two groups achieved satisfactory perioperative blood glucose control. Finger tip blood glucose was 5.0-9.0 mmol/L before meal, 7.0-10.0 mmol/L 2-hour after meal, and 4.0-8.0 mmol/L at 10 PM and 3 AM. No hypoglycemia (<3.5 mmol/L) was found in all the patients. The time to first flatus after surgery was (62.4±15.7) in the enteral group, significantly earlier than (90.8±22.4) h in the parenteral group (P<0.01). Postoperative nutritional indices and associated complications were not significantly different between two groups (all P>0.05). Cost in the enteral group was significantly lower than that in the parenteral group [(650.8±45.8) RMB vs. (3016.5±152.6) RMB, P<0.01].


CONCLUSIONS
Perioperative nutrition support can effectively control blood glucose and improve perioperative nutritional status simultaneously for esophageal cancer patients with diabetes mellitus. Compared with parenteral nutrition, enteral nutrition can accelerate the recovery of gastric bowel function and reduce the cost of nutritional support.
Department of Thoracic Surgery, Fujian Provincial Tumor Hospital, Fujian Medical University, Fuzhou 350014, China. 39859870@qq.com.
Shuo-yan
SY
Liu
Xiao-feng
XF
Chen
Feng
F
Wang
Qing-feng
QF
Zheng
Jian-jian
JJ
Wang
D000328:Adult; D000368:Aged; D003920:Diabetes Mellitus / Q000628:therapy*; D004750:Enteral Nutrition; D004938:Esophageal Neoplasms / Q000150:complications / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D019990:Perioperative Care; D011446:Prospective Studies; D016896:Treatment Outcome