Patients with gastrointestinal(GI) malignancy usually suffer from malnutrition and suppressed immune function, which might be worsened by major elective surgery.Enteral nutrition has been emphasized for patients with GI malignancy during the perioperative period to accelerate bowel function recovery, and improve nitrogen balance and immune response while reducing postoperative complications and hospitalization time.Early enteral nutrition(EEN) can promote the postoperative recovery of GI function and has been considered to have other advantages such as the reduction of medical cost and maintenance of intestinal barrier function. Immunonutrition containing special compounds like omega-3-unsaturated fatty acids has been put forward to modulate the immune response and improve the immune function in patients with cancer, which may have an better effect on the immune system than standard enteral nutrition. However, studies on immuno-enhanced early enteral nutrition after a resectable GI malignancy surgery are scarce. The aim of this study was to determine whether immuno-enhanced early enteral nutrition(IEEN) is more effective than standard early enteral nutrition(SEEN) on nutritional status, immune function, surgical outcomes,time to adjuvant chemotherapy and days of hospitalization after laparoscopic GI surgery.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
200
Immediately drip 37°C saline 20 ml/h and exchange to drip 37°C enteral nutrition fluid concerning omega-3-unsaturated fatty acids 20 ml/h at postoperative 6 h via jejunostomy tube or nasogastric tube
Immediately drip 37°C saline 20 ml/h and exchange to drip 37°C standard enteral nutrition fluid 20 ml/h at postoperative 6 h via jejunostomy tube or nasogastric tube
Jinling Hospital
Nanjing, Jiangsu, China
Time to tolerate IEEN/SEEN
Time frame: 30 days after operation
Overall morbidity rate of IEEN/SEEN
Time frame: 60 days after operation
Mortality rate of IEEN/SEEN after operation
Time frame: 60 days after operation
Energy metabolism
Time frame: 10 days after operation
Time to the first postoperative adjuvant chemotherapy
Time frame: 30 days after operation
Nutritional status in postoperative day1and 7 of IEEN/SEEN
Time frame: 7 days after operation
Immune function in postoperative day 1 and 7
Time frame: 7 days after operation
Postoperative hospital stay length
Time frame: 60 days after operation
Rehospitalization rate
Time frame: 30 days after discharge
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