Influence of Different Nutritional Approaches on Liver Function in Patients afer Esophagectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LIUGao-hua , WANGXiao-yong , ZHANFu-sheng ,  TANGXiao-jun

Department of Cardiothoracic Surgery, Afliated Hospital of Luzhou Medical College, Luzhou 646000, Sichuan, P. R. China;

Corresponding author：

TANGXiao-jun, Email: tangxiaojun73@163.com

Keywords：

Esophageal cancer; Liver function; Enteral nutrition; Total parenteral nutrition

DOI：

10.7507/1007-4848.20150120

Video：

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Objective To explore influence of different nutritional approaches on liver function in patients after esophagectomy. Methods A total of 160 patients with esophageal cancer who underwent surgical treatment were divided into a enteral nutrition (EN) group and a total parenteral nutrition (TPN) group according to different medical staff. There were 80 patients in each group. Two and 7 days postoperatively, albumin (ALB), prealbumin (PA), alanine aminotransferase (ALT) and total bilirubin (TB) of the 2 groups were examined to evaluate liver function. Results Abnormities in liver function (ALB, PA, ALT, TB) was common phenomenon in esophageal cancer patients, but there was no statistical difference in ALB, PA, ALT, TB on the 2nd postoperative day between the EN group and the TPN group (P > 0.05). On the 7th postoperative day, liver functions were improved than those on the 2nd postoperative day in the two groups. And frequencies of liver function abnormity in the EN group were significantly lower than those in the TNP group (P < 0.05). Conclusion Compared with TPN, EN has advantages in facilitating hepatic protein synthesis and recovery of liver function after esophagectomy.

Citation： LIUGao-hua, WANGXiao-yong, ZHANFu-sheng, TANGXiao-jun. Influence of Different Nutritional Approaches on Liver Function in Patients afer Esophagectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(5): 459-462. doi: 10.7507/1007-4848.20150120 Copy

1.	栾正刚, 马晓春.围手术期肝功能障碍类型及处理.中国实用外科杂志, 2014, 34(2):123-126.
2.	Tsujinaka T, Kido Y, Ogawa Y, et al. Clinical analysis of postoperative hyperbilirubinemia following resection of esophageal cancer. Nihon Geka Gakkai Zasshi, 1987, 88(8):939-946.
3.	徐达夫, 尤振兵, 朱卫国, 等.快速康复外科对食管癌患者肝功能的影响.中华实验外科杂志, 2012, 29(10):1920.
4.	Liu CL, Du Z, Lou C, et al. Enteral nutrition is superior to total parenteral nutrition for pancreatic cancer patients who underwent pancreaticoduodenectomy. Asia Pac J Clin Nutr, 2011, 20(2):154-160.
5.	Powell-Tuck J. Nutritional interventions in critical illness. Proc Nutr Soc, 2007, 66(1):16-24.
6.	徐洪波, 黄和平.食管癌术后早期肠内营养的临床应用.肿瘤, 2007, 27(10):832-834.
7.	Baker A, Wooten LA, Malloy M. Nutritional considerations after gastrectomy and esophagectomy for malignancy. Curr Treat Options Oncol, 2011, 1(1):85-95.
8.	Seike J, Tangoku A, Yuasa Y, et al. Te effect of nutritional suport on the immune function in the acute postoperative period after esophageal cancer surgery:total parenteral nutrition versus enteral nutrition. J Med Invest, 2011, 58(1-2):75-80.
9.	谢天鹏, 赵雍凡, 彭林, 等.食管癌术后早期全肠内营养支持对肝功能的影响.中国临床营养杂志, 2007, 15(2):95-98.
10.	Gabor S, Renner H, Matzi V, et al. Early enteral feeding compared with parenteral nutrition after oesophageal or oesophagogastric resection and reconstruction. Br J Nutr, 2005, 93(4):509-513.
11.	宁桂芝, 夏宏伟, 吕丽艳, 等.食道癌病人围手术期肠内营养支持.齐齐哈尔医学院学报, 2009, 30(15):1856-1857.
12.	鱼晓波, 阮征, 黄海龙, 等.食管癌术后早期肠内营养对肠粘膜屏障功能及免疫功能的影响.临床外科杂志, 2013, 21(1):39-42.
13.	李宁.肠功能障碍的肠内营养策略.肠外与肠内营养, 2010, 17(4):173-174.
14.	Soybel DI, Matthews JB, Silen W. Elemental diet and IV-TPNinduced bacterial translocation is associated with loss of intestinal mucosal barrier function against bacteria. Ann Surg, 1997, 225(2):238-239.
15.	Hong L, Wang X, Wu J, et al. Miochondria-initiated apoptosis triggered by oxidative injury play a role in total parenteral nutritionassociated liver dysfunction in infant rabbit model. J Pediatr Surg, 2009, 44(9):1712-1718.
16.	洪莉, 王翔, 吴江, 等.胃肠外营养相关肝损伤机制的实验研究.上海交通大学学报(医学版), 2006, 26(11):1201-1205.
17.	Tannuri U. Oxidative injury and hepatocyte apoptosis in total parenteral nutrition-associated liver dysfunction. J Pediatr Srug, 2007, 42(3):596.

1. 栾正刚, 马晓春.围手术期肝功能障碍类型及处理.中国实用外科杂志, 2014, 34(2):123-126.
2. Tsujinaka T, Kido Y, Ogawa Y, et al. Clinical analysis of postoperative hyperbilirubinemia following resection of esophageal cancer. Nihon Geka Gakkai Zasshi, 1987, 88(8):939-946.
3. 徐达夫, 尤振兵, 朱卫国, 等.快速康复外科对食管癌患者肝功能的影响.中华实验外科杂志, 2012, 29(10):1920.
4. Liu CL, Du Z, Lou C, et al. Enteral nutrition is superior to total parenteral nutrition for pancreatic cancer patients who underwent pancreaticoduodenectomy. Asia Pac J Clin Nutr, 2011, 20(2):154-160.
5. Powell-Tuck J. Nutritional interventions in critical illness. Proc Nutr Soc, 2007, 66(1):16-24.
6. 徐洪波, 黄和平.食管癌术后早期肠内营养的临床应用.肿瘤, 2007, 27(10):832-834.
7. Baker A, Wooten LA, Malloy M. Nutritional considerations after gastrectomy and esophagectomy for malignancy. Curr Treat Options Oncol, 2011, 1(1):85-95.
8. Seike J, Tangoku A, Yuasa Y, et al. Te effect of nutritional suport on the immune function in the acute postoperative period after esophageal cancer surgery:total parenteral nutrition versus enteral nutrition. J Med Invest, 2011, 58(1-2):75-80.
9. 谢天鹏, 赵雍凡, 彭林, 等.食管癌术后早期全肠内营养支持对肝功能的影响.中国临床营养杂志, 2007, 15(2):95-98.
10. Gabor S, Renner H, Matzi V, et al. Early enteral feeding compared with parenteral nutrition after oesophageal or oesophagogastric resection and reconstruction. Br J Nutr, 2005, 93(4):509-513.
11. 宁桂芝, 夏宏伟, 吕丽艳, 等.食道癌病人围手术期肠内营养支持.齐齐哈尔医学院学报, 2009, 30(15):1856-1857.
12. 鱼晓波, 阮征, 黄海龙, 等.食管癌术后早期肠内营养对肠粘膜屏障功能及免疫功能的影响.临床外科杂志, 2013, 21(1):39-42.
13. 李宁.肠功能障碍的肠内营养策略.肠外与肠内营养, 2010, 17(4):173-174.
14. Soybel DI, Matthews JB, Silen W. Elemental diet and IV-TPNinduced bacterial translocation is associated with loss of intestinal mucosal barrier function against bacteria. Ann Surg, 1997, 225(2):238-239.
15. Hong L, Wang X, Wu J, et al. Miochondria-initiated apoptosis triggered by oxidative injury play a role in total parenteral nutritionassociated liver dysfunction in infant rabbit model. J Pediatr Surg, 2009, 44(9):1712-1718.
16. 洪莉, 王翔, 吴江, 等.胃肠外营养相关肝损伤机制的实验研究.上海交通大学学报(医学版), 2006, 26(11):1201-1205.
17. Tannuri U. Oxidative injury and hepatocyte apoptosis in total parenteral nutrition-associated liver dysfunction. J Pediatr Srug, 2007, 42(3):596.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Influence of Different Nutritional Approaches on Liver Function in Patients afer Esophagectomy

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