Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Oct 27, 2023; 15(10): 2222-2233
Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2222
Examining the impact of early enteral nutritional support on postoperative recovery in patients undergoing surgical treatment for gastrointestinal neoplasms
Zhi Chen, Bo Hong, Jiang-Juan He, Qian-Qian Ye, Qiao-Yi Hu
Zhi Chen, Qian-Qian Ye, Department of Rehabilitation, Xiangshan First People’s Hospital Medical and Health Group, Ningbo 315700, Zhejiang Province, China
Bo Hong, Department of Gastroenterology, Xiangshan First People’s Hospital Medical and Health Group, Ningbo 315700, Zhejiang Province, China
Jiang-Juan He, Center of Nursing Management, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310006, Zhejiang Province, China
Qiao-Yi Hu, Department of Nutrition, Xiangshan First People’s Hospital Medical and Health Group, Ningbo 315700, Zhejiang Province, China
Author contributions: Chen Z and Hong B contributed equally to this work; Chen Z, Hong B, He JJ, Ye QQ, and Hu QY designed the research study; Chen Z, Hong B, and He JJ performed the research, analyzed the data, and wrote the manuscript; Ye QQ and Hu QY contributed new reagents and analytic tools; All authors have read and approved the final manuscript.
Supported by the Xiangshan County Science and Technology Bureau, Project Name Regional Quality Control on the Impact and Value of Endoscopic Screening for Intestinal Adenomas, No. 2022C6018.
Institutional review board statement: The study was conducted with the approval of the Ethics Committee of the Medical and Healthcare Group of the First People’s Hospital of Xiangshan County, with the ethical approval number: 2023-(k)-41.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report having no relevant conflicts of interest for this article.
Data sharing statement: The data collected for this study are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiao-Yi Hu, MBChB, Intermediate Nutrition Technician, Department of Nutrition, Xiangshan First People’s Hospital Medical and Health Group, No. 291 Donggu Road, Dandong Street, Ningbo 315700, Zhejiang Province, China. 15058210622@163.com
Received: July 6, 2023
Peer-review started: July 6, 2023
First decision: July 27, 2023
Revised: August 2, 2023
Accepted: August 18, 2023
Article in press: August 18, 2023
Published online: October 27, 2023
Abstract
BACKGROUND

Patients with gastrointestinal tumors often suffer from poor nutritional status during treatment. Surgery is the main treatment for these patients, but the long postoperative recovery period is often accompanied by digestive and absorption dysfunction, leading to further deterioration of the nutritional status. Early enteral nutrition support is hypothesized to be helpful in improving this situation, but the exact effects have yet to be studied in depth.

AIM

To observe the effect of early enteral nutritional support on postoperative recovery in patients with surgically treated gastrointestinal tract tumors, with the expectation that by improving the nutritional status of patients, the recovery process would be accelerated and the incidence of complications would be reduced, thus improving the quality of life.

METHODS

A retrospective analysis of 121 patients with gastrointestinal tract tumors treated in our hospital from January 2020 to January 2023 was performed. Fifty-three of these patients received complete parenteral nutrition support as the control group for this study. The other 68 patients received early enteral nutritional support as the observation group of this study. The clinical indicators comparing the two groups included time to fever, time to recovery of postoperative bowel function, time to postoperative exhaustion, and length of hospital stay. The changes in immune function and nutritional indexes in the two groups were compared. Furthermore, we utilized the SF-36 scale to compare the changes in the quality of life between the two groups of patients. Finally, the occurrence of postoperative complications between the two patient groups was also compared.

RESULTS

The postoperative fever time, postoperative bowel function recovery time, postoperative exhaustion time, and hospitalization time were all higher in the control group than in the observation group (P < 0.05). The levels of CD3+, CD4+, immunoglobulin (Ig) A, IgM, and IgG in the observation group were significantly higher than those in the control group at 1 d and 7 d postoperatively, while CD8+ was lower than in the control group (P < 0.05). Total protein, albumin, prealbumin, and transferrin levels were significantly higher in the observation group than in the control group at 7 d postoperatively (P < 0.05). The SF-36 scores of patients in the observation group were significantly higher than those in the control group (P < 0.0001). The overall incidence of adverse reactions after the intervention was significantly lower in the control group than in the observation group (P = 0.021).

CONCLUSION

We found that patients with gastrointestinal tumors are nutritionally vulnerable, and early enteral nutrition support programs can improve the nutritional status of patients and speed up postoperative recovery. This program can not only improve the immune function of the patient and protect the intestinal function, but it can also help to improve the quality of life of the patient. However, this program will increase the incidence of complications in patients. Caution should be taken when adopting early enteral nutrition support measures for patients with gastric cancer. The patient's condition and physical condition should be comprehensively evaluated and closely monitored to prevent possible complications.

Keywords: Early enteral nutrition support, Surgical treatment, Gastrointestinal tumor, Postoperative recovery, Immune function

Core Tip: This study demonstrated the critical role of early enteral nutritional support in the postoperative recovery of patients undergoing surgery for gastrointestinal tract tumors. This strategy not only helped to improve patient nutritional status, accelerate postoperative recovery, and reduce the incidence of complications but also improved patient quality of life by enhancing immune function and protecting intestinal function. Early enteral nutritional support becomes an important component of postsurgical care for gastrointestinal tumors and helps to improve the overall outcome of patients.