title: [Study on early postoperative nutritional support in elderly patients with gastric cancer].
abstract: OBJECTIVE
  To explore the optimal postoperative nutritional support in elderly patients with gastric cancer.
  
  
  METHODS
  One hundred and twenty elderly patients with gastric cancer undergoing radical gastrectomy were prospectively enrolled from January 2010 to March 2013 and randomly divided into total parenteral nutrition group(TPN, n=40), early total enteral nutrition group (TEN, n=40) and enteral plus parenteral nutrition group(EN+PN, n=40). Clinical charasteristics including treatment tolerance, nutritional indexes, immune indexes, time to first flatus, incidence of postoperative infection and anastomotic leakage, were analyzed and compared.
  
  
  RESULTS
  Treatment tolerance in EN+PN group(97.5%, 39/40) was significantly higher than that in TPN group(82.5%, 33/40) and TEN group(80.0%, 32/40)(both P<0.05). The nutritional indices, including prealbumin, albumin, transferrin, body mass index, and the incidence of anastomotic leakage were similar in the 3 groups(P>0.05). The immune indices, including CD3, CD4, CD4/CD8, were significantly reduced after operation in each group. However, they were significantly higher in EN+PN group and TEN group than those in TPN group(both P<0.05). Furthermore, compared to the TPN group, the incidence of postoperative infection(surgical site infection, pulmonary infection, abdominal infection) was significantly lower and time to first flatus was significantly shorter in EN+PN group and TEN group.
  
  
  CONCLUSIONS
  Early enteral nutrition after gastric cancer surgery is safe, simple and feasible. EN plus PN is the best way to administer postoperative nutritional support in elderly patients with gastric cancer.
authors.affiliation: Department of General Surgery, The First Affiliated Hospital, Xiamen University, Xiamen 361000, China. 13959277591@163.com.
authors.forename: Zhao-hui
authors.initials: ZH
authors.lastname: Liu
authors.forename: Guo-qiang
authors.initials: GQ
authors.lastname: Su
authors.forename: Si-yu
authors.initials: SY
authors.lastname: Zhang
authors.forename: Jing-bin
authors.initials: JB
authors.lastname: Zhang
authors.forename: Xiao-rong
authors.initials: XR
authors.lastname: Huang
mesh_terms: D000368:Aged; D057868:Anastomotic Leak; D004750:Enteral Nutrition; D005743:Gastrectomy; D006801:Humans; D015596:Nutrition Assessment; D010288:Parenteral Nutrition; D010289:Parenteral Nutrition, Total; D011183:Postoperative Complications; D011184:Postoperative Period; D013274:Stomach Neoplasms / Q000601:surgery*