Korean J Gastroenterol.  2012 Jun;59(6):407-413. 10.4166/kjg.2012.59.6.407.

The Comparison between Early Enteral Nutrition and Total Parenteral Nutrition after Total Gastrectomy in Patients with Gastric Cancer: The Randomized Prospective Study

• Kim HU
• Chung JB
• Kim CB

• KMID: 1792845
• DOI: http://doi.org/10.4166/kjg.2012.59.6.407

Abstract

BACKGROUND/AIMS
Early enteral nutrition (EEN) has benefits in reducing infectious complication, length of stay (LOS) and preserving liver function. There are few data about the effect of EEN in the patients who had total gastrectomy. The aim of this randomized and prospective study was to evaluate the effect of EEN after total gastrectomy on nutritional status, liver function, complications and LOS, compared to total parenteral nutrition (TPN) in patients with gastric cancer.
METHODS
Among 56 patients with gastric cancer, 36 and 20 were randomly assigned to EEN and TPN groups, and finally 17 and 16 completed EEN and TPN schedules, respectively. The nutritional parameters, liver function, LOS and abdominal symptoms were compared between 2 groups on pre-operative day and post-operative 7th day.
RESULTS
There was no significant difference in the nutritional parameters, liver function between EEN and TPN groups. Vomiting and abdominal distention were more frequent in EEN than TPN group (2 vs. 0 cases, p=0.485; 1 vs. 0 case, p=1.000, respectively), while increased AST, ALT and total bilirubin were more common in TPN than EEN group (4 vs. 2 cases, p=0.398; 1 vs. 0 case, p=0.485, respectively without statistical significance). LOS was shorter in EEN than TPN group without statistical significance (12 vs. 13 days, p=0.289).
CONCLUSIONS
No significant differences were found in the nutritional status parameters, liver function, complications and LOS between EEN and TPN groups on 7th day after total gastrectomy. Further large scale studies on the advantages and disadvantages of EEN after total gastrectomy are warranted.

Keyword

Early enteral nutrition; Nasojejunal feeding tube; Total gastrectomy; Length of stay; Complication

MeSH Terms

Adult
Aged
Aged, 80 and over
Alanine Transaminase/blood
Aspartate Aminotransferases/blood
Bilirubin/blood
*Enteral Nutrition
Female
Gastrectomy
Humans
Length of Stay
Male
Middle Aged
*Parenteral Nutrition, Total
Postoperative Care
Prospective Studies
Stomach Neoplasms/*surgery

Figure

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  Fig. 1 Selection and drop-out of patients. The early enteral nutrition (EEN) group was finally 17 patients and the total parenteral nutrition (TPN) group was 16 patients, after the drop-out with the shown causes during study period.

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  Fig. 2 The changes of nutritional parameters and length of stay (LOS) in early enteral nutrition (EEN) group and total parenteral nutrition (TPN) group on postoperative 7th day. AST and ALT were increased in both groups, but triglyceride (TG), transferrin, and prealbumin were decreased in both groups. There was no significant difference in any parameters and LOS.

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