Synergistic Effect of Early Enteral and Parenteral Nutrition on Immune and Nutritional Recovery Following Gastric Cancer Surgery

Jialong Tao¹Xiuluan Du²Haixia Xu³Liya Dai⁴Chen Zhang⁴Wenwen Gao⁴Sijia Huang¹Yanjie Wang¹Jing Sun^5*Wenlu Zhao^1*

• ¹Second Affiliated Hospital of Soochow University, Suzhou, China
• ²Affilitated Hospital of Medical School Nanjing University, Suzhou, China
• ³Zhucheng People's Hospital, Zhucheng, China
• ⁴The Second Affiliated Hospital of Soochow University, Suzhou, China
• ⁵Suzhou Xiangcheng People's Hospital, Suzhou, China

Objective: In this study, we aimed to explore the effects of early enteral nutrition (EN) combined with parenteral nutrition (PN) on the immune function and nutritional indices in patients with gastric cancer (GC) after surgery. Methods: One hundred patients , who underwent radical gastrectomy and were admitted toin our hospital between June 2022 and June 2023 were selected and divided into control (CG) and observation (OG) groups. The patients in the CG received early EN support, whereas those in the OG received early EN combined with supportive PN treatment. Gastrointestinal functional recovery, length of hospital stay, nutritional indices, immune function, inflammatory stress index, and the incidence of complications in both groups were compared. Results: The time to first flatus, time to first defecation, time to tolerance of semi-liquid diet and the length of hospital stay first exhaust time, first defecation time, semi-liquid diet time, and length of hospital stay were shorter in the OG than that in the CG (P < 0.05). After nutritional support, the ALB, TP, and TRF levels in the OG were higher than those in the CG (P < 0.05). In addition, immunoglobulin (Ig)G, IgM, and IgA levels were higher in the OG group than those in the CG group (P < 0.05). Moreover, TNF-α, IL-6, and CRP levels in the OG were lower, compared to those in the CG (P < 0.05). The incidence of complications was lower in the OG than in the CG (P < 0.05). Conclusion: For patients with GC, the combined application of early EN and PN support measures after surgery can accelerate the recovery of gastrointestinal function, reduce complications, improve the body's nutritional status, promote the recovery of immune function, and lower the inflammatory stress response. The combined application of early EN and PN support after surgery in patients with GC could accelerate the recovery of gastrointestinal function, reduce complications, improve the nutritional status of the body, promote the recovery of immune function, and reduce the inflammatory stress response.