The Comparison between Early Enteral Nutrition and Total Parenteral Nutrition after Total Gastrectomy in Patients with Gastric Cancer: The Randomized Prospective Study

Abstract

Background/Aims: Early enteral nutrition (EEN) has benefits in reducing infectious complication, length of stay (LOS) and preserving liver function. There are few data about the effect of EEN in the patients who had total gastrectomy. The aim of this randomized and prospective study was to evaluate the effect of EEN after total gastrectomy on nutritional status, liver function, complications and LOS, compared to total parenteral nutrition (TPN) in patients with gastric cancer. Methods: Among 56 patients with gastric cancer, 36 and 20 were randomly assigned to EEN and TPN groups, and finally 17 and 16 completed EEN and TPN schedules, respectively. The nutritional parameters, liver function, LOS and abdominal symptoms were compared between 2 groups on pre-operative day and post-operative 7th day. Results: There was no significant difference in the nutritional parameters, liver function between EEN and TPN groups. Vomiting and abdominal distention were more frequent in EEN than TPN group (2 vs. 0 cases, p=0.485; 1 vs. 0 case, p=1.000, respectively), while increased AST, ALT and total bilirubin were more common in TPN than EEN group (4 vs. 2 cases, p=0.398; 1 vs. 0 case, p=0.485, respectively without statistical significance). LOS was shorter in EEN than TPN group without statistical significance (12 vs. 13 days, p=0.289). Conclusions: No significant differences were found in the nutritional status parameters, liver function, complications and LOS between EEN and TPN groups on 7th day after total gastrectomy. Further large scale studies on the advantages and disadvantages of EEN after total gastrectomy are warranted. (Korean J Gastroenterol 2012;59:407-413)

Assessment of Total Parenteral Nutrition administration among Intensive Care Unit patients at Omdurman Military Hospital, Sudan

“…Forty percent of our study participants were older patients, aged above 60 years, this was consistent with studies [11,17,18,19] . Males who received TPN were more than females, similar to [11,19] and controversial to another study [17].…”

Enteral Nutrition versus Parenteral Nutrition after Major Abdominal Surgery in Patients with Gastrointestinal Cancer: A Systematic Review and Meta-Analysis

“…This study found that the duration of treatment, in general, continued from POD1 until POD7 (with only a few exceptions, ie, TEN was only studied for 3–5 days in three studies24 26 28). Our results suggested that EN use is preferable to TPN use for patients after major abdominal surgery.…”

Short-term evaluation of immune levels and nutritional values of EN versus PN in gastric cancer: a systematic review and a meta-analysis

“…This meta-analysis included 14 studies comparing EN and PN in gastric cancer resections. There were 10 papers from China, 3 papers from Japan, and 1 paper from Korea: Li et al [36], Wang et al [37], Li et al [38], Chen et al [1], Liu et al [39], Li et al [40], Gao [41], Hongyi et al [42], Chen [43], Li et al [44], Nomura et al [45], Akashi et al [46], Kamei et al [47], and Kim et al [48] . Nine papers were randomized with n = 1437 participants, and 5 papers were retrospective studies with n = 421 participants.…”