The short-term impact of hypocaloric and hyponitrogenic parenteral nutrition in patients after laparoscopic radical resection for colorectal cancer

Abstract

Objective To evaluate the short-term impact of hypocaloric and hyponitrogenic parenteral nutrition ( PN ) in patients after laparoscopic radical resection for colorectal cancer.Methods Eightyfour patients with colorectal carcinoma were randomly divided into two groups. Study group ( n =42 ) received calorie (73.35 ±8.37) kJ/(kg·day) and nitrogen (0.10 ±0.01 ) mol/(kg·d) using a standardized regimen ( KabivenTM PI, Fresenius Kabi, Germany ). Control group ( n =42 ) received calorie ( 125.58 ±8.37 ) kJ/(kg·day) and nitrogen (0.24 ±0.06) mol/(kg·day) in regular 3 liter bag. PN was infused continuously for 5 days postoperatively. Biochemical indicators, infectious complications and postoperative hospital stay were recorded to identify the difference between the two groups.Results The fluctuations of blood glucose levels in study group were lower than those in control group with significant difference ( P ＜ 0.05 ). Comparison of serum concentrations of total protein, albumin and prealbumin between two groups had no significant difference ( P ＞ 0.05 ). Comparison of the complication rate of pulmonary infection,urinary tract infection and wound infection between two groups had no significant difference (P ＞0.05). The total infectious complication rate in study group was 7.1 ％,significantly lower than that in control group (23.8％,P ＜ 0.05 ). The phlebitis rate in study group was 2.4％,significantly lower than that in control group (21.4％,P ＜0.01 ),and the systemic inflammatory response syndrome (SIRS) rate in study group was 21.4％,significantly lower than that in control group (47.6％,P ＜ 0.05 ). But there was no significant difference in the postoperative hospital stay between the two groups ( P ＞ 0.05 ).Conclusion Hypocaloric and hyponitrogenic PN after laparoscopic radical resection of colorectal cancer can control postoperative blood glucose levels better than traditional PN does, and decrease the rate of infectious complications,phlebitis and SIRS. Key words: Parenteral nutrition; Colorectal tumor; Laparoscope; Blood glucose