Postoperative nutrition in patients with esophageal cancer: a prospective randomized controlled study

Objective To observe the effects of total enteral nutrition(TEN) and early combined parenteral nutrition(PEN+ TEN) in patients with esophageal cancer after operation. Methods The prospective, random, controlled clinical trial was adopted. One hundred patients receiving esophageal cancer operation were randomly assigned to the TEN group(50 cases) and the PEN+ TEN group(50 cases). The differences in nutritional status, inflammatory response, immune status and postoperative complications were compared in the two groups before and after operation. Results The levels of total serum protein, albumin or retinol binding protein were higher in the PEN group than the TEN group at the 10th day after operation, respectively[(60.1±6.2)g/L vs(55.3±9.3)g/L, (36.4±4.2)g/L vs(34.6±1.6)g/L, (43.3±5.9)g/L vs(34.9±3.3)g/L, P<0.05] . The levels of ESR or CRP were higher in PEN+ TEN group than the TEN group at the 10th day after operation, respectively[(54.9±25.8)mm/h vs(31.8±14.2)mm/h, (30.9±13.2)g/L vs(15.8±6.1)g/L, P<0.01] . The levels of CD3+ , CD4+ , or CD8+ were higher at the 10th day after operation than at the day before surgery in TEN group[(59.6±9.8)%vs(68.3±4.4)%, (41.7±7.8)%vs(46.5±5.5)%, (23.2±5.5)%vs(20.0±2.7)%, P<0.05], but not in PEN+ TEN group. The levels of IgA or IgG were significant higher in the TEN group than the PEN+ TEN group at the 10th day after operation[(1.9±0.5)g/L vs(1.6±0.3)g/L, (11.9±3.3)g/L vs(9.4±2.2)g/L, P<0.01]. Conclusion The inflammatory reaction and immune function in TEN group are better than those in PEN+ TEN group. Although the nutritional status is worse in the TEN group than that in the PEN group, but the rate of postoperative complications has not increased. Key words: Postoperative; Esophageal cancer; Total enteral nutrition; Parenteral nutrition; Immune status