[Effect of early enteral nutrition on immune response and clinical outcomes after esophageal cancer surgery].
OBJECTIVE
To evaluate the effect of early enteral nutrition(EEN) on immune response and clinical outcomes after esophageal cancer operation.


METHODS
Sixty patients with esophageal cancer undergoing radical operation between March 2010 and July 2011 were randomly divided into two groups using envelope method: EEN group(n=30, administration of water and enteral nutrition early after operation) and TPN group(n=30, administration of total parenteral nutrition). Two groups both received 7-day nutrition support. Immune indexes(CD3(+), CD4(+), CD8(+), CD4(+)/CD8(+)) and serum nutritional indexes(albumin, pre-albumin, transferrin) were measured before operation and 1-, 3-, and 7-day after operation. The time to first flatus, length of postoperative hospital stay, total hospitalization cost, and postoperative complication were recorded.


RESULTS
As compared to TPN group, the time to first flatus was significantly shorter in EEN group[(66.5±7.3) h vs. (75.1±6.8) h, P<0.01], as was hospital stay[(7.8±1.1) d vs. (9.3±1.3) d, P<0.01]. Total hospitalization cost[(36 210±3810) yuan vs. (39 731±4013) yuan, P<0.01] was lower in EEN group as compared to TPN group. There was no significant difference in postoperative complication rate between the two groups[13.3%(3/30) vs. 20.0%(6/30), P>0.05]. The levels of CD3(+), CD4(+), CD4(+)/CD8(+), albumin, prealbumin and transferrin were significantly higher in EEN group as compared to TPN group on postoperative day 3 and 7(all P<0.05), while CD8(+) was significantly lower in EEN group(P<0.05).


CONCLUSIONS
EEN can promote early recovery of gastrointestinal function, improve nutritional and immune function, and therefore lead to fast postoperative recovery in esophageal cancer patients.
Department of Thoracic Surgery, The Fourth Hospital of Harbin Medical University, Harbin 150001, China. cuijian_111@163.com.
Guibin
G
Zhao
Shouqiang
S
Cao
Kai
K
Zhang
Yanzhong
Y
Xin
Jingquan
J
Han
Qing
Q
Dong
Jian
J
Cui
D004750:Enteral Nutrition; D004938:Esophageal Neoplasms / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D015596:Nutrition Assessment; D011183:Postoperative Complications; D011184:Postoperative Period