CUI Yaping , ZHAO Rui , WANG Yong , LI Zhigui , SU Xiangnan , WAN Qianyi , XIA Lin , ZHOU Yong , WU Xiaoting
  • Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
WU Xiaoting, Email: wxt1@medmail.com.cn
gastric cancer; ω-3 polyunsaturated fatty acids; alanyl-glutamine; inflammatory response; immune function
10.7507/1007-9424.201904001
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Objective To investigate the effects of early enteral nutrition containing ω-3 polyunsaturated fatty acids combined with intravenous infusion of alanyl-glutamine on inflammatory response and immune function of postoperative gastric cancer patients.Methods A total of 110 patients, accepting radical operation for gastric cancer in West China Hospital of Sichuan University during October 2017 to December 2018, were prospectively incorporated in the study and were randomly divided into 2 groups equally. Patients in the control group were enterally fed with a formula containing ω-3 polyunsaturated fatty acids for 6 consecutive days after surgery. Patients in the experimental group accepted the same enteral feeding but combined with intravenous infusion of alanyl-glutamine (20 g/d). Both enteral feeding and intravenous infusion started within 24 hours after surgery. Peripheral venous blood was gathered within 3 days before surgery and on the morning of the first, third, and seventh postoperative days to detect inflammatory, immunological, and nutritional indexes. Complications, length of hospital stay, and hospital cost were also taken notes.Results Fifty-two patients in the control group and fifty-two patients in the experimental group respectively finished the study. In both groups, 3 patients withdrew from the study for inadequacy of radical operation. Neutrophilic granulocyte percentage, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) on the third postoperative day, C-reactive protein (CRP), procalcitonin (PCT), IL-6, and TNF-α on the seventh postoperative day, were significantly lower in the experimental group (P<0.05). Immunological indexes including immunoglobulin G (IGG), immunoglobulin A (IGA), percentage of CD3+ T cells, and percentage of CD4+ T cells, nutritional markers including total protein (TP), plasma albumin (ALB), and prealbumin (PAB) were significantly higher in the experimental group on the seventh postoperative day (P<0.05). When the study ended, none significant differences of the rates of both infectious complications (wound infection, intra-abdominal infection, pulmonary infection, urinary system infection, blood system infection, and anastomotic fistula) and noninfectious complications (diarrhea, abdominal distension, and abdominal pain) were observed between the two groups (P>0.05). Time of the first anal discharge, length of hospital stay, and hospitalization cost between the two groups were not significantly different neither (P>0.05).Conclusion Early enteral nutrition containing ω-3 polyunsaturated fatty acids combined with intravenous infusion of alanyl-glutamine contributes to reduce inflammatory response and improve immune function and nutrition status of patients with gastric cancer after surgery.

Citation： CUI Yaping, ZHAO Rui, WANG Yong, LI Zhigui, SU Xiangnan, WAN Qianyi, XIA Lin, ZHOU Yong, WU Xiaoting. Effects of early enteral nutrition containing ω-3 polyunsaturated fatty acids combined withintravenous infusion of alanyl-glutamine on inflammatory response and immune function of postoperative gastric cancer patients. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(7): 785-791. doi: 10.7507/1007-9424.201904001 Copy

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