Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2024; 16(12): 3737-3744
Published online Dec 27, 2024. doi: 10.4240/wjgs.v16.i12.3737
Effects of comprehensive nutrition support on immune function, wound healing, hospital stay, and mental health in gastrointestinal surgery
Ling Zhu, Jun Cheng, Fei Xiao, Yan-Yan Mao
Ling Zhu, Fei Xiao, Yan-Yan Mao, Department of Gastrointestinal Surgery, Wuhan Fourth Hospital, Wuhan 430000, Hubei Province, China
Jun Cheng, Department of Gastrointestinal Surgery, Qianjiang Central Hospital, Qianjing 433100, Hubei Province, China
Co-first authors: Ling Zhu and Jun Cheng.
Author contributions: Zhu L, Cheng J, Xiao F and Mao YY contributed equally to this work; Xiao F and Mao YY designed the research study, performed the primary literature and data extraction; Zhu L and Cheng J analyzed the data and wrote the manuscript, and responsible for revising the manuscript for important intellectual content; All authors read and approved the final version.
Institutional review board statement: The study was reviewed and approved by Wuhan Fourth Hospital, No. 2023-012.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at lingzhu901118@163.com. Participants gave informed consent for data sharing.
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: Ling Zhu, BM BCh, Nurse, Department of Gastrointestinal Surgery, Wuhan Fourth Hospital, Gutian Third Road, Qiaokou District, Wuhan 430000, Hubei Province, China. lingzhu901118@163.com
Received: July 18, 2024
Revised: August 19, 2024
Accepted: August 27, 2024
Published online: December 27, 2024
Processing time: 132 Days and 0.8 Hours
Abstract
BACKGROUND

Postoperative patients undergoing gastrointestinal surgery often encounter challenges such as low immune function, delayed wound healing owing to surgical trauma, and increased nutritional demands during recovery.

AIM

To assess the effect of comprehensive nutritional support program on immune function and wound healing in patients undergoing gastrointestinal surgery.

METHODS

This retrospective comparative study included 60 patients who underwent gastrointestinal surgery, randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received comprehensive nutritional support, including a combination of enteral and parenteral nutrition, whereas the control group received only conventional comprehensive nutritional support. Evaluation indicators included immune function markers (e.g., white blood cell count, lymphocyte subsets), wound healing (wound infection rate, healing time), pain score [visual analog scale (VAS) score], and psychological status (anxiety score, depression score) 7 days post-surgery) and duration of stay.

RESULTS

The immune function of patients in the experimental group was significantly better than that in the control group. The white blood cell count was 8.52 ± 1.19 × 109/L in the experimental group vs 6.74 ± 1.31 × 109/L (P < 0.05). The proportion of CD4+ T cells was higher in the experimental group (40.09% ± 4.91%) than that in the control group (33.01% ± 5.08%) (P < 0.05); the proportion of CD8+ T cells was lower (21.79% ± 3.38% vs 26.29% ± 3.09%; P < 0.05). The CD4+/CD8+ ratio was 1.91 ± 0.32 in the experimental group whereas 1.13 ± 0.23 in the control group (P < 0.05). The wound infection rate of the experimental group was significantly lower than that of the control group (10% vs 30%, P < 0.05), and the wound healing time was shorter (10.35 ± 2.42 days vs 14.42 ± 3.15 days, P < 0.05). The VAS score of the experimental group was 3.05 ± 1.04, and that of the control group was 5.11 ± 1.09 (P < 0.05); the anxiety score (Hamilton Anxiety Rating Scale) was 8.88 ± 1.87, and that of the control group was 12.1 ± 3.27 (P < 0.05); the depression score (Hamilton Depression Rating Scale) was 7.37 ± 1.41, and that of the control group was 11.79 ± 2.77 (P < 0.05). In addition, the hospitalization time of the experimental group was significantly shorter than that of the control group (16.16 ± 3.12 days vs 20.93 ± 4.84 days, P < 0.05).

CONCLUSION

A comprehensive nutritional support program significantly enhances immune function, promote wound healing, reduces pain, improves psychological status, and shortens hospitalization stays in patients recovering from gastrointestinal surgery.

Keywords: Comprehensive nutritional support; Gastrointestinal surgery; Immune function; Wound healing; Pain score; Psychological score; Hospital stay

Core Tip: In the rehabilitation management of patients after gastrointestinal surgery, a comprehensive nutritional support program can significantly improve immune function, promote wound healing, reduce pain and anxiety, and shorten hospitalization time. Therefore, comprehensive nutritional support should be considered an important part of the rehabilitation management of patients after gastrointestinal surgery and deserves to be widely promoted and applied in clinical practice.