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Efficiency of early enteral nutrition after esophagectomy: a prospective, randomized and controlled clinical trial

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Author:
YU Xiao-bo(Department of Thoracic Surgery,Shanghai First People's Hospital,Shanghai 200080,China)
RUAN Zheng(Department of Thoracic Surgery,Shanghai First People's Hospital,Shanghai 200080,China)
HUANG Hai-long(Department of Thoracic Surgery,Shanghai First People's Hospital,Shanghai 200080,China)
ZHENG Jian(Department of Thoracic Surgery,Shanghai First People's Hospital,Shanghai 200080,China)
CHAI Xiao-jun(Department of Thoracic Surgery,Shanghai First People's Hospital,Shanghai 200080,China)
HUANG Hai-hua(Department of Thoracic Surgery,Shanghai First People's Hospital,Shanghai 200080,China)
ZHANG Xiao-miao(Department of Thoracic Surgery,Shanghai First People's Hospital,Shanghai 200080,China)
Journal Title:
China Medicine
Issue:
Volume 07, Issue 11, 2012
DOI:
10.3760/cma.j.issn.1673-4777.2012.11.023
Key Word:
Esophageal neoplasms;Enteral nutrition;Parenteral nutrition

Abstract: Objective To evaluate efficiency and security of early enteral nutrition in patients after esophagectomy.Methods A randomized controlled clinical trial was conducted regarding the role of early enteral nutrition(EN) with parenteral nutrition (PN) in 120 patients after esophagectomy.The intake was isonitrogenic and isocalorie in the two groups.Nutrition state test before operation,1th and 8th day after operation was analyzed.Nitrogen balance was measured daily.Plasma concentrations of D (-)-lactate,diamine oxidase (DAO) and endotoxin were determined on the 1th,4th and 8th days after operation.Infection rate and complication rate of nutrtion support after operation were observed.Results ① The concentration of serum albumin and prealbumin in the group of EN was higher than that in the PN group and the concentration of blood glucose,γ-GT,AKP,TB,DB was lower than that in the PN group (P<0.05).② Nitrogen balance was superior in EN group than those in the PN group.③ The concentrations of D(-)-lactate,DAO and endotoxin of the EN group were significantly lower than those of the PN group on the eighth day after operation (P <0.01).④ The infectious rates of blood,lung,gut tract in EN group were lower than those in the PN group(P<0.05).⑤ There was no severe complications of nutrition supply in EN group,The time of passage of gas by anus of EN group was shorter and the cost of nutrition was less than that in the PN group(P <0.05).Conclusions ① EN is safe and feasible after esophagectomy.② Campared with PN support,EN support can more efficiently ameliorate the nutrition state of the patients receiving esophagectomy.③ EN plays an important role in recovery of gut barrier function after esophagectomy.④ EN support can reduce the rate of postoperative infection and decrease the cost in hospital.

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