Perioperative application of immunomodulating enteral nutrition support on patients with total gastrectomy

Objective To investigate the effect of perioperative immunomodulating enteral nutrition(EN)support on nutritional status,immune function and inflammatory response of the patients who underwent total gastrectomy.Methods Fourty-eight patients who had undergone total radical gastrectomy were randomly divided into group A(n=24)and group B(n=24).In group A,enteral nutrition support was given for 5 days before operation and 8 days from six hours after operation by an oral or nose-gastric tube.In group A,all patients did not receive conventional intestinal preparation before operation.In group B,EN support was given for 8 days from six hours after operation by an oral or nose-gastric tube and they received conventional intestinal preparation before operation.The levels of total protein,albumin,IgA,CD4,CD4/CD8,CRP and TNF-α were measured on day-1,1 and 8 after operation.Results There was no significant difference in intestinal cleanliness between the two groups.Compared with group B,the levels of total protein and albumin were much higher in group A,and increased after operation,but there was no significant difference between the two groups.In group A,the postoperative levels of CRP and TNF-α decreased gradually and were much lower than those in group B(P0.05).In group A,the postoperative levels of IgA,CD4 and CD4/CD8 increased gradually and were much higher than those in group B(P0.05).Conclusion Perioperative immunomodulating enteral nutrition support could improve nutritional status,enhance immunity,reduce inflammatory response,and promote recovery.