title: The Effects of Pre-Operative Enteral Nutrition from Nasal Feeding Tubes on Gastric Outlet Obstruction.
abstract: We examined gastric outlet obstruction (GOO) patients who received two weeks of strengthening pre-operative enteral nutrition therapy (pre-EN) through a nasal-jejenal feeding tube placed under a gastroscope to evaluate the feasibility and potential benefit of pre-EN compared to parenteral nutrition (PN). In this study, 68 patients confirmed to have GOO with upper-gastrointestinal contrast and who accepted the operation were randomized into an EN group and a PN group. The differences in nutritional status, immune function, post-operative complications, weight of patients, first bowel sound and first flatus time, pull tube time, length of hospital stay (LOH), and cost of hospitalization between pre-operation and post-operation were all recorded. Statistical analyses were performed using the chi square test andt-test; statistical significance was defined asp< 0.05. The success rate of the placement was 91.18% (three out of 31 cases). After pre-EN, the levels of weight, albumin (ALB), prealbumin (PA), and transferrin (TNF) in the EN group were significantly increased by pre-operation day compared to admission day, but were not significantly increased in the PN group; the weights in the EN group were significantly increased compared to the PN group by pre-operation day and day of discharge; total protein (TP), ALB, PA, and TNF of the EN group were significantly increased compared to the PN group on pre-operation and post-operative days one and three. The levels of CD3+, CD4+/CD8+, IgA, and IgM in the EN group were higher than those of the PN group at pre-operation and post-operation; the EN group had a significantly lower incidence of poor wound healing, peritoneal cavity infection, pneumonia, and a shorter first bowel sound time, first flatus time, and post-operation hospital stay than the PN group. Pre-EN through a nasal-jejunum feeding tube and placed under a gastroscope in GOO patients was safe, feasible, and beneficial to the nutrition status, immune function, and gastrointestinal function, and sped up recovery, while not increasing the cost of hospitalization.
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China. chenzhihua198613@sina.com.
authors.forename: Zhi-Hua
authors.initials: ZH
authors.lastname: Chen
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China. fyyyczh@sina.com.
authors.forename: Su-Yong
authors.initials: SY
authors.lastname: Lin
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China. daijin@yahoo.com.
authors.forename: Qi-Bao
authors.initials: QB
authors.lastname: Dai
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China. ribo191@163.com.
authors.forename: Jin
authors.initials: J
authors.lastname: Hua
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China. chenshaoqin@medmail.com.cn.
authors.forename: Shao-Qin
authors.initials: SQ
authors.lastname: Chen
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D002921:Cicatrix / Q000175:diagnosis / Q000191:economics / Q000601:surgery*; D003365:Costs and Cost Analysis; D004750:Enteral Nutrition / Q000009:adverse effects / Q000191:economics; D005240:Feasibility Studies; D005260:Female; D017219:Gastric Outlet Obstruction / Q000175:diagnosis / Q000191:economics / Q000601:surgery*; D017721:Hospital Costs; D006801:Humans; D015994:Incidence; D007441:Intubation, Gastrointestinal / Q000009:adverse effects / Q000191:economics; D007583:Jejunum; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010288:Parenteral Nutrition / Q000009:adverse effects / Q000191:economics; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D011300:Preoperative Care / Q000191:economics; D011379:Prognosis; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000191:economics / Q000601:surgery*; D014945:Wound Healing
keywords: enteral nutrition; gastric outlet obstruction; gastroscope; immune function; pre-operative