Clinical effects of total protein and short peptide enteral nutrition during recovery after radical gastrectomy

摘要

Background and Objectives: Enteral nutrition (EN) plays a vital role in promoting the recovery of patients after surgery. This study aims to clarify the effects of total protein enteral nutrition ( TPEN) and short peptide enteral nutrition (SPEN) on the recovery of patients after radical gastrectomy. Methods and Study Design: Patients underwent radical gastrectomy were randomly divided into a TPEN (n=60) or SPEN group (n=60). These two kinds of EN were fed 24 hours after radical gastrectomy with increasing dose from 10 kcal/kg to maximal 25 kcal/kg on postoperative day (POD) 5 and with the maximal dose in following days. Supplemental parenteral nutrition was given for replenishing energy deficits. The tube feeding was discontinued when oral intake increased to sixty percent of the target requirements. The postoperative recovery was evaluated on POD 1 and POD 7. Results: On POD 7, the serum prealbumin (transthyretin) was higher in the TPEN than the SPEN group (p<0.001). The patients in the TPEN group had a higher incidence of abdominal distension (p=0.043), but had a lower incidence of diarrhea ( p=0.016) compared to the SPEN group. The anal exhaust time of patients in the TPEN group was postponed (p=0.020), but the postoperative hospitalization time (p=0.005) and total hospitalization time (p=0.027) were shortened compared to the SPEN group. No significant differences were observed between the two groups in any other indicators. Conclusions: SPEN is suitable for early and TPEN for later stage recovery after radical gastrectomy.