The clinical significance of preoperative administration of enteral immunonutrition to patients with malignant gastrointestinal tumors

Objective: To evaluate the clinical significance of preoperative administration of immuno-enhancing enteral nutrition to the patients with malignant gastrointestinal tumors.Methods: Fifty malnourished patients with malignant gastrointestinal tumors were randomly divided into two groups by block randomization.There were 25 cases in each group.The patients of two groups were assigned to receive either an immuno-enhancing enteral nutritional emulsion(TPF-T,brand name Suportan) or a general enteral nutrition(brand name Nutrison powder Ensure) for 7 days before tumor resection.The daily nutritional diet contained 104.6 kJ·kg-1·d-1 and nitrogen 0.18 g·kg-1·d-1.Before and on the 8th day after the nutritional support,numbers of peripheral blood lymphocyte,liver function,percentages of lymphocyte subsets(CD3+,CD4+,CD8+,CD4+/CD8+) and immunoglobulins(IgA,IgM,IgG) were determined.Tolerance of the nutrition,incidence of infectious complications and anastomosis site leakage were observed.Results: Patients in the two groups were all tolerant to the enteral nutritions and no infectious complications and leakage occurred.There was no clinical significance for the changes of peripheral lymphocyte counts and liver function.In the immuno-enhancing enteral nutrition group,serum level of CD8+ on the 8th day after nutritional support was significantly reduced[(29.27±6.16)% vs(25.79±5.53)%,P0.05)],while CD4+/CD8+ ratio was significantly increased[(1.41±0.18) vs(1.66±0.26),P0.01],and serum concentration of IgM was significantly higher than that in the general enteral nutrition group[(1.38±0.41) vs(1.16±0.28),P0.05].Conclusion: Preoperative administration of enteral immunonutrition can improve the immune function of patients with malignant gastrointestinal tumors.It is safe and feasible.