Comparison of the Influence of Enteral Nutrition and Total Parenteral Nutrition on Liver,Kidney and Gastrointestinal Function in Patients after Esophagectomy

Objective To investigate the influence of enteral nutrition(EN) and total parenteral nutrition(TPN)on liver,kidney and gastrointestinal function in patients after esophagectomy. Methods A total of 124 patients with esophageal cancer who underwent esophagectomy in the Affiliated Hospital of Guangdong Medical College from January2012 to August 2013 were enrolled in this study. There were 71 male and 53 female patients with their average age of 59.7years(range 31 to 85 years). All the patients were randomly divided into an experimental group and a control group.Postoperatively,patients in the experimental group received EN via nasogastric/nasointestinal tube,and patients in the control group received TPN. Preoperatively,1,3 and 7 days postoperatively,plasma alanine transaminase(ALT),aspartate transaminase(AST),indirect bilirubin(I_BIL),direct bilirubin(DB),total bilirubin(TB),total protein(TP) and albumin(ALB) were examined to evaluate liver function,blood urea nitrogen(BUN) and serum creatinine(Scr) were examined toevaluate renal function. Postoperative time to first audible bowel sounds,time to first flatus,and time to first stool were examined to evaluate gastrointestinal function. Results There was no statistical difference in ALT,AST,I_BIL,DB or TB preoperatively and on the 1st postoperative day between the 2 groups( P 0.05),but these parameters of the experimental group were significantly lower than those of the control group on the 3rd and 7th postoperative day( P 0.05). There was no statistical difference in TP or ALB between the 2 groups( P 0.05). There was no statistical difference in BUN or Scr preoperatively,on the 1st or 3rd postoperative day between the 2 groups( P 0.05). BUN( 4.94±1.07 mmol/L vs. 6.67±2.88 mmol/L,P 0.05) and Scr( 52.50±12.46 μmol/L vs. 68.23±7.61 μmol/L,P 0.05) of the experimental group were significantly lower than those of the control group on the 7th postoperative day. Postoperative time to first audible bowel sounds( 42.00±1.68 hours vs. 50.00±1.54 hours),time to first flatus( 64.15±10.35 hours vs. 70.64±14.73 hours) and time to first stool( 4.20±1.50 days vs. 5.20 ±1.40 days) of the experimental group were significantly shorter than those of the control group( P 0.05). Conclusion Postoperative EN can promote the recovery of gastrointestinal function,and has less influence on liver and kidney function,which is beneficial to postoperative recovery and morbidity reduction after esophagectomy.