Clinical application of early enteral nutrition following radical resection for patients with gastric cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIANG Tao , GUO Yulan ,  WU Xiaoting

Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

WU Xiaoting, Email: wxt1@medmail.com.cn

Keywords：

gastric cancer; early enteral nutrition; radical resection; gastrointestinal function

DOI：

10.7507/1007-9424.201708057

Video：

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Objective To analyze clinical value of early enteral nutrition following radical resection of gastric cancer. Methods Seventy-six patients with gastric cancer underwent radical resection from May 1, 2016 to July 1, 2016 in the West China Hospital of Sichuan University were included according to the inclusion criteria and exclusion criteria, then were randomly divided into observation group (36 cases) and control group (40 cases). The patients in the observation group received the enteral nutrition on day 2 following the surgery, in the control group received the conventional management. The gastrointestinal recovery and the adverse reaction were compared in these two groups. The preoperative and postoperative laboratory indicators and the body weight of the patients in both groups were analyzed. Results ① The general data such as age, gender, and body weight had no significant differences in these two groups (P>0.05). ② The first anus exhaust time and the first defecation time of the observation group were significantly shorter than those of the control group (P<0.05). ③ The adverse reaction rate of the observation group was significantly lower than that of the control group (P<0.05). ④ On admission, the serum albumin, urea nitrogen, creatinine, and lymphocyte count had no significant differences in these two groups (P>0.05). On day 5 after the operation, the serum albumin of the observation group was significantly higher than that of the control group (P<0.05). ⑤ The body weight had no significant difference in these two groups before the operation (P>0.05), which in the observation group was significantly heavier than that of the control group on day 30 after the operation (P<0.05). Conclusion Preliminary results of limited cases in this study show that early enteral nutrition following radical resection of gastric cancer is safe and effective, it could promote gastrointestinal function resumption and effectively improve nutritional status.

Citation： LIANG Tao, GUO Yulan, WU Xiaoting. Clinical application of early enteral nutrition following radical resection for patients with gastric cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(2): 197-201. doi: 10.7507/1007-9424.201708057 Copy

1.	Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2.	Tian J, Chen JS. Nutritional status and quality of life of the gastric cancer patients in Changle County of China. World J Gastroenterol, 2005, 11(11): 1582-1586.
3.	杜艷平, 李玲玲, 賀青, 等. 胃腸道腫瘤患者的營養風險篩查及營養狀況評價. 中華胃腸外科雜志, 2012, 15 (5): 460-463.
4.	李文英, 曹淑紅, 張曉峰, 等. 胃癌術后患者生活質量研究. 現代預防醫學, 2011, 38(21): 4441-4443.
5.	裴成林. 快速康復外科對胃腸道手術患者圍術期的作用. 大家健康 (學術版), 2014, 8(15): 135-136.
6.	余倫. 胃癌患者術前營養狀況對遠期預后影響分析. 中華普外科手術學雜志 (電子版), 2016, 10(1): 44-46.
7.	Sachlova M, Majek O, Tucek S. Prognostic value of scores based on malnutrition or systemic inflammatory response in patients with metastatic or recurrent gastric cancer. Nutr Cancer, 2014, 66(8): 1362-1370.
8.	李劍, 周福有, 耿明飛, 等. 快速康復外科理念下食管癌術后腸內營養途徑的選擇. 河南外科學雜志, 2013, 19(3): 8-10.
9.	王文娟, 孫冬巖, 孫笑非, 等. 腸道屏障功能損傷與細菌易位研究進展. 飼料研究, 2012, (7): 38-39.
10.	袁琮韡, 李俊生, 嵇振嶺, 等. 全腸外營養及早期腸內營養在胃癌全胃切除術后患者中的對比研究, 中國普外基礎與臨床雜志, 2010, 17(4): 357-361.
11.	李國立, 李寧, 黎介壽. 胃癌病人的臨床營養支持. 外科理論與實踐, 2006, 11(6): 486-488.
12.	馮立, 王峰, 董培德, 等. 胃癌患者根治術后早期腸內營養的臨床療效觀察. 中國普外基礎與臨床雜志, 2014, 21(3): 325-329.
13.	梁冀望, 鄭志超, 趙巖, 等. 胃癌根治術應用快速康復外科的系統評價. 中國腫瘤, 2012, 21(1): 75- 80.
14.	張振彬, 寧進堯, 胡金晨, 等. 快速康復外科在腹腔鏡胃癌根治術圍手術期的應用. 腹腔鏡外科雜志, 2012, 17(9): 671-673.
15.	Wang D, Kong Y, Zhong B, et al. Fast-track surgery improves postoperative recovery in patients with gastric cancer: a randomized comparison with conventional postoperative care. J Gastrointest Surg, 2010, 14(4): 620-627.
16.	Rothnie NG, Harper RA, Catchpole BN. Early postoperative gastrointestinal activity. Lancet, 1963, 2(7298): 64-67.
17.	彭鵬, 黃杰安. 危重癥患者早期腸內營養最新進展. 臨床薈萃, 2011, 26-(6): 543-546-50.
18.	趙秉清, 祝振忠, 王征. 危重患者早期腸內營養支持治療研究. 中外醫療, 2011, (1): 48-49.
19.	楊朝綱, 熊斌, 楊帥龍. 胃癌術后早期腸內營養支持的研究現狀. 中華普通外科雜志, 2015, 30(6): 500-502.
20.	何彥坤, 張靜, 何若沖. 腸內與腸外營養對胃癌根治手術后患者恢復情況的 Meta 分析. 中華臨床醫師雜志 (電子版), 2013, 7(5): 2077-2081.
21.	王鴻波, 王華龍, 王新民, 等. 營養風險篩查在結直腸癌快速康復外科治療中的作用. 現代生物醫學進展, 2014, 14(30): 5926-5929.
22.	Mueller C, Compher C, Ellen DM, et al. A.S.P.E.N. clinical guidelines: Nutrition screening, assessment, and intervention in adults. JPEN J Parenter Enteral Nutr, 2011, 35(1): 16-24.
23.	Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003, 22(3): 321-336.
24.	米磊, 仲蓓, 張佃良, 等. 胃癌患者術后早期腸內營養對臨床結局的影響. 中華胃腸外科雜志, 2012, 15(5): 464-467.
25.	黎介壽. 腸內營養—外科臨床營養支持的首選途徑. 中國實用外科雜志, 2003, 23(2): 67.
26.	朱俊杰, 郭明賢, 王士祺, 等. 胃癌患者術后早期腸內營養耐受狀況及其相關因素. 中華臨床營養雜志, 2014, 22(3): 131-135.
27.	黃濤陽, 張應輝, 黃和. 腸內營養劑的臨床合理應用. 醫藥導報, 2011, 30(10): 1369-1372.

1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China, 2015. CA Cancer J Clin, 2016, 66(2): 115-132.
2. Tian J, Chen JS. Nutritional status and quality of life of the gastric cancer patients in Changle County of China. World J Gastroenterol, 2005, 11(11): 1582-1586.
3. 杜艷平, 李玲玲, 賀青, 等. 胃腸道腫瘤患者的營養風險篩查及營養狀況評價. 中華胃腸外科雜志, 2012, 15 (5): 460-463.
4. 李文英, 曹淑紅, 張曉峰, 等. 胃癌術后患者生活質量研究. 現代預防醫學, 2011, 38(21): 4441-4443.
5. 裴成林. 快速康復外科對胃腸道手術患者圍術期的作用. 大家健康 (學術版), 2014, 8(15): 135-136.
6. 余倫. 胃癌患者術前營養狀況對遠期預后影響分析. 中華普外科手術學雜志 (電子版), 2016, 10(1): 44-46.
7. Sachlova M, Majek O, Tucek S. Prognostic value of scores based on malnutrition or systemic inflammatory response in patients with metastatic or recurrent gastric cancer. Nutr Cancer, 2014, 66(8): 1362-1370.
8. 李劍, 周福有, 耿明飛, 等. 快速康復外科理念下食管癌術后腸內營養途徑的選擇. 河南外科學雜志, 2013, 19(3): 8-10.
9. 王文娟, 孫冬巖, 孫笑非, 等. 腸道屏障功能損傷與細菌易位研究進展. 飼料研究, 2012, (7): 38-39.
10. 袁琮韡, 李俊生, 嵇振嶺, 等. 全腸外營養及早期腸內營養在胃癌全胃切除術后患者中的對比研究, 中國普外基礎與臨床雜志, 2010, 17(4): 357-361.
11. 李國立, 李寧, 黎介壽. 胃癌病人的臨床營養支持. 外科理論與實踐, 2006, 11(6): 486-488.
12. 馮立, 王峰, 董培德, 等. 胃癌患者根治術后早期腸內營養的臨床療效觀察. 中國普外基礎與臨床雜志, 2014, 21(3): 325-329.
13. 梁冀望, 鄭志超, 趙巖, 等. 胃癌根治術應用快速康復外科的系統評價. 中國腫瘤, 2012, 21(1): 75- 80.
14. 張振彬, 寧進堯, 胡金晨, 等. 快速康復外科在腹腔鏡胃癌根治術圍手術期的應用. 腹腔鏡外科雜志, 2012, 17(9): 671-673.
15. Wang D, Kong Y, Zhong B, et al. Fast-track surgery improves postoperative recovery in patients with gastric cancer: a randomized comparison with conventional postoperative care. J Gastrointest Surg, 2010, 14(4): 620-627.
16. Rothnie NG, Harper RA, Catchpole BN. Early postoperative gastrointestinal activity. Lancet, 1963, 2(7298): 64-67.
17. 彭鵬, 黃杰安. 危重癥患者早期腸內營養最新進展. 臨床薈萃, 2011, 26-(6): 543-546-50.
18. 趙秉清, 祝振忠, 王征. 危重患者早期腸內營養支持治療研究. 中外醫療, 2011, (1): 48-49.
19. 楊朝綱, 熊斌, 楊帥龍. 胃癌術后早期腸內營養支持的研究現狀. 中華普通外科雜志, 2015, 30(6): 500-502.
20. 何彥坤, 張靜, 何若沖. 腸內與腸外營養對胃癌根治手術后患者恢復情況的 Meta 分析. 中華臨床醫師雜志 (電子版), 2013, 7(5): 2077-2081.
21. 王鴻波, 王華龍, 王新民, 等. 營養風險篩查在結直腸癌快速康復外科治療中的作用. 現代生物醫學進展, 2014, 14(30): 5926-5929.
22. Mueller C, Compher C, Ellen DM, et al. A.S.P.E.N. clinical guidelines: Nutrition screening, assessment, and intervention in adults. JPEN J Parenter Enteral Nutr, 2011, 35(1): 16-24.
23. Kondrup J, Rasmussen HH, Hamberg O, et al. Nutritional risk screening (NRS 2002): a new method based on an analysis of controlled clinical trials. Clin Nutr, 2003, 22(3): 321-336.
24. 米磊, 仲蓓, 張佃良, 等. 胃癌患者術后早期腸內營養對臨床結局的影響. 中華胃腸外科雜志, 2012, 15(5): 464-467.
25. 黎介壽. 腸內營養—外科臨床營養支持的首選途徑. 中國實用外科雜志, 2003, 23(2): 67.
26. 朱俊杰, 郭明賢, 王士祺, 等. 胃癌患者術后早期腸內營養耐受狀況及其相關因素. 中華臨床營養雜志, 2014, 22(3): 131-135.
27. 黃濤陽, 張應輝, 黃和. 腸內營養劑的臨床合理應用. 醫藥導報, 2011, 30(10): 1369-1372.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical application of early enteral nutrition following radical resection for patients with gastric cancer

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