title: Early enteral nutrition in combination with parenteral nutrition in elderly patients after surgery due to gastrointestinal cancer.
abstract: OBJECTIVE
  To evaluate the therapeutic effects of nutritional support via different routes in elderly patients after surgery for gastrointestinal (GI) cancer.
  
  
  METHODS
  105 patients with GI cancer were randomly divided into early enteral nutrition (EEN) group (n = 35), total parenteral nutrition (TPN) group (n = 35) and EN+PN group (n = 35).
  
  
  RESULTS
  The nutrition status and immunity were significantly compromised in all patients, while the liver function was improved at 3 days after surgery as compared to those before surgery. At 7 days after surgery, they returned to preoperative level. The nutrition status was comparable among 3 groups at 3 and 7 days after surgery (P > 0.05). ALT, AST, ALP and GGT in TNP group were significantly higher than those in EEN group and EN+PN group (P < 0.05), whereas there was no significant difference in the liver function between EEN group and EN+PN group (P > 0.05). The CD3+ cells, CD4+ cells and CD4/CD8 in EEN group and EN+PN group were significantly higher than those in TPN group (P < 0.05), but significant difference was not observed between EEN group and EN+PN group (P > 0.05). The NK cells in EN+PN group were significantly higher than in TPN group (P < 0.01). The incidence of diarrhea in EEN group was significantly higher than in TPN group and EN+PN group (P < 0.05).
  
  
  CONCLUSIONS
  EN+PN is superior to EEN alone and TPN alone in the old patients with GI cancer in reducing the postoperative complications, improving the immunity and decreasing the hospital stay.
authors.affiliation: Department of General Surgery, People's Hospital of Putuo District Shanghai, 200060, China.
authors.forename: Dongping
authors.initials: D
authors.lastname: Huang
authors.affiliation: Department of General Surgery, People's Hospital of Putuo District Shanghai, 200060, China.
authors.forename: Zhufeng
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Department of General Surgery, People's Hospital of Putuo District Shanghai, 200060, China.
authors.forename: Jianwei
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Scientific Research, Tongji Hospital affiliated to Tongji University Shanghai, 200065, China.
authors.forename: Zhaozai
authors.initials: Z
authors.lastname: Shen
keywords: Gastric cancer; colorectal cancer; enteral nutrition; parenteral nutrition