Supplemental parenteral nutrition improves patient outcomes after esophageal cancer surgery: A single-center randomized controlled study.

Abstract

We investigated the effect of supplemental parenteral nutrition comprising parenteral nutrition (PN) and enteral nutrition (EN) on the postoperative nutritional status, immune function, and inflammatory response of patients with esophageal cancer. Seventy-two patients with esophageal cancer were divided into the experimental group (PN + EN group; n = 36) and control group (total EN [TEN] group; n = 36). In the PN + EN group, EN and PN were administered on postoperative days 4 to 8. In the TEN group, EN was initiated on postoperative days 1 to 8. Changes in the nutritional status, immune function, and inflammatory indices were compared between groups. Before surgery, the prealbumin (PA) values of both groups were lower than normal, and the C3, C4, and C-reactive protein (CRP) levels were above normal. The IgA, IgG, IgM, CD3, CD4, and CD4/CD8 levels were lower than normal, and the CD8 level was increased. On postoperative day 1, the PA levels of both groups decreased (P > .05), C3, C4, and CRP levels increased, and IgA, IgG, IgM, CD3, CD4, and CD4/CD8 decreased to values noted before surgery. On postoperative day 7, PA levels of the PN + EN group were significantly higher than those of the TEN group (P < .05). The CRP level of the PN + EN group was significantly lower than that of the TEN group (P < .05). IgA, IgG, and CD4 were significantly higher in the PN + EN group than in the TEN group (P < .05). Supplemental parenteral nutrition for perioperative esophageal cancer patients can maintain the optimal nutritional status, improve immune function, and reduce the inflammatory stress response.