Abstract

Objective To explore the effect of early enteral nutrition(EN) on postoperative nutritional status, intestinal permeability, and immune function in elderly patients with esophageal cancer. Methods A total of 96 patients with esophageal cancer who underwent surgical treatment in our hospital from June 2007 to December 2012 were enrolled in this study. They were divided into enteral nutrition(EN) group(n=50) and parenteral nutrition(PN) group(n=46) based on the nutrition support modes. The body weight, time to first flatus/defecation, average hospital stay, complications and mortality after the surgery as well as the liver function indicators were recorded and analyzed. Peripheral blood samples were collected on the days 1, 4, and 7 after surgery. The plasma diamine oxidase(DAO) activity and D-lactate level were determined to assess the intestinal permeability. The plasma endotoxin levels were determined using dynamic turbid metric assay to assess the protective effect of EN on intestinal mucosal barrier. The postoperative blood levels of inflammatory cytokines and immunoglobulins were determined using enzyme-linked immunosorbent assay(ELISA). Results After the surgery, the time to first flatus/defecation, average hospital stay, and complications were significantly less in the EN group than in the PN group(P<0.05), whereas the EN group had significantly higher albumin levels than the PN group(P<0.05). On the 7th post-operative day, the DAO activity, D-lactate level and endotoxin contents were significantly lower in the EN group than in the PN group(all P<0.05). In addition the EN group had significantly higher IgA, IgG, IgM, and CD4 levels than the PN group(P<0.05) but significantly lower IL-2, IL-6, and TNF-α levels(P<0.05). Conclusion In elderly patients with esophageal cancer, early EN after surgery can effectively improve the nutritional status, protect intestinal mucosal barrier(by reducing plasma endoxins), and enhance the immune function. Key words: Enteral nutrition; Nutritional status; Intestinal permeability; Endoxin; Immune function

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