Prospective study of 3 different feeding fashions in patients underwent gastrectomy for cancer

Purpose To evaluate the effects of parenteral nutrition (PN), enteral nutrition (EN) and complementary nutrition (CN) on the recovery of patients received gastrectomy for cancer. Methods Ninety consecutive patients received surgery for carcinoma of stomach were randomized into 3 groups. 1) PN(n = 30). 2) EN(n = 30):The nutrition was given continuously in 24 hours at about 80 ml/hr via catheter jejunostomy. 3) CN (n = 30): On POD1, 75 percent of the whole daily nutrition were given by PN, the rest 25 percent by EN. From POD2 EN was progressed to the optimal goal of 80ml/hr by POD5 and PN was reduced gradually to nothing. All the feedings were started isocaloricly and isonitrogenously on POD1 and were maintained by POD5. The pre and optoperative body weight,the time needed for bowel movement to recover and the postoperative complications were recored. The serum albumin and the blood WBC count were determined pre and postoperatively. Results 1) The time needed for bowel movement to recover (Hrs) was sighficantly shorter in groups CN (36. 7±0.5) and EN (34. 8 ± 0. 6) than that in gnp PN (72. 5 ±0. 3), P0.05. 2) The rate of main postoperative complications was significantIy lower in CN (26. 7%) than those in EN (100%) and PN (56.7%), P 0.05.3) On AOD5, there was no significant difference in the percentage Of patients with normal count of blood WBC (PN 96. 7%, EN 100%,CN 96. 7%, P0. 05), the level of serum albumin (g/dl) (PN 4. 1 ± 0. 5,EN 4. 0±0. 3,CN 3. 9 ± 0. 1,P0. 05) and the body weight (kg) (PN 62. 6 ± 0. 4, EN 63.1 ± 0. 3, CN 62. 9 ± 0. 4, P 0. 05) among the 3 groups. But on POD6, the level of serum albumin(g/dl) (PN 4.0±0. 3,EN 3. 1 ± 0. 2,CN 4. 1± 0. 4) and the body weight (kg) (PN 62. 7 ± 0. 5,EN 58. 0 ±0. 3,CN 63. 0±0. 2) were significantly higher in groups CN and PN than those in group EN (P 0. 05);The Percentage of patients with normal count of blood WBC was significantly higher in CN (93. 3%) and EN (90%) than that in PN (66. 7%), P0. 05. Conlusions Complementary nutrition of the combination of PN and EN could enhance the recovery of bowel movement and the returning of the blood WBC count to normal postoperatively. It could keep the serum albumin level and the body weight perioperatively. The optoperative complications were significantly reduced in CN group. CN is the best feeding fashion for patients received gastrectomy for cancer.