The effects of early enteral nutrition on the nutritional statuses, gastrointestinal functions, and inflammatory responses of gastrointestinal tumor patients

Rong Chen; Weijuan Yin; Hui Gao; Hongpeng Zhang; Yingqi Huang

The effects of early enteral nutrition on the nutritional statuses, gastrointestinal functions, and inflammatory responses of gastrointestinal tumor patients

Am J Transl Res. 2021 Jun 15;13(6):6260-6269. eCollection 2021.

Authors

Rong Chen¹, Weijuan Yin¹, Hui Gao², Hongpeng Zhang³, Yingqi Huang^{4

5}

Affiliations

¹ Department of General Surgery and Gastroenterology, Eastern Hospital of Yangzhou University Yangzhou 225001, Jiangsu Province, China.
² Comprehensive Oncology, Baotou Cancer Hospital Baotou 014000, Inner Mongolia Autonomous Region, China.
³ Department of Gastrointestinal Surgery, Southern Theater Command General Hospital Guangzhou 510016, China.
⁴ Clinical Nutrition Division, Wujin Hospital Affiliated With Jiangsu University Changzhou 213017, Jiangsu Province, China.
⁵ The Wujin Clinical College of Xuzhou Medical University Changzhou 213017, Jiangsu Province, China.

PMID: 34306365
PMCID: PMC8290805

Abstract

Objective: This paper was designed to investigate the effects of early enteral nutrition (EEN) on the nutritional statuses, gastrointestinal functions, and inflammatory responses of gastrointestinal tumor patients.

Methods: A total of 194 gastrointestinal tumor patients treated in our hospital from May 2017 to February 2019 were recruited as the study cohort. Among them, 101 patients were administered enteral nutrition (the study group), and 93 patients were administered parenteral nutrition (the control group). The two groups were compared in terms of their nutritional statuses, gastrointestinal functions, inflammatory responses, and other indicators.

Results: On the third day after the operation (postoperative 3 d), the serum albumin (ALB) and prealbumin (PA) levels were significantly reduced in both groups (P>0.05). On the seventh day after the operation (postoperative 7 d), the two nutritional indices increased significantly in both groups (P<0.05), and were significantly higher in the study group (P<0.05). Compared with the control group, the patients in the study group experienced shorter lengths of stay (LOS), earlier first anal exhaust times, and faster intestinal peristalsis recovery times (P<0.05). On the third day after the operations, the high-sensitive C-reactive protein (hs-CRP) and prostaglandin E (PGE) levels were significantly reduced in both groups (P<0.05), and the decrease was significantly greater in the study group (P<0.05). In addition, the CD3⁺, CD4⁺, CD8⁺ and CD4⁺/CD8⁺ levels were significantly reduced in both groups on the third day after the operation (P>0.05). On the seventh day after the operation, the first three immune indices increased significantly in both groups (P<0.05), and they were significantly higher in the study group (P<0.05). The incidences of vomiting, diarrhea, and abdominal distension in the study group were significantly lower than they were in the control group (P<0.05). After the treatment, the patients' quality of life (QOL) was significantly higher in the study group (P<0.05).

Conclusion: For gastrointestinal tumor patients, EEN can improve their gastrointestinal functions, enhance their immune functions, and reduce their expressions of inflammatory cytokines while improving their nutritional statuses and QOL.

Keywords: Early enteral nutrition; gastrointestinal functions; gastrointestinal tumor; inflammatory responses; nutritional status.