Efficacy of early enteral nutrition to enhance recovery after major abdominal surgeries in cancer patients

Abstract

Background Malnutrition is a significant prognostic factor in surgical cancer patients, especially when the malignancy is localized to the gastrointestinal tract. Aim The goal of this study was to evaluate the impact of early enteral feeding on nutritional status and clinical outcomes in patients who had undergone abdominal surgery for cancer. Patients and methods Forty patients, ranging in age from 20 to 60 years, admitted to the postoperative surgical ICU underwent preoperative nutritional assessment and were followed daily from the morning of postoperative day 1 in the ICU until the evening of day 4 for the possibility of starting enteral nutrition safely. Participants were differentiated into early and late groups according to the time of establishment of enteral feeding. To compare early and late groups of the studied patients, clinical and laboratory nutritional markers and clinical outcomes were traced and statistically analyzed. Results Both groups had 12 (60%) males and eight (40%) females, with a mean±SD age of 43.6±8.15 years in the early group and 41.75±6.65 years in the late group. The early group had a substantially higher mean percentage BMI gain (2.50±0.35) than the late group (0.89±0.20). The early group had statistically higher serum prealbumin levels than the late group after 4 days. Early enteral feeding increased the prealbumin percentage by 25.37±5.93 compared with 15.93±1.98 in the late group. Early enteral feeding increased the total cholesterol levels. Early enteral feeding had a mean cholesterol percentage change of 32.04±6.74% compared with 17.23±4.23% in the late group. Early enteral nutrition patients spent 3.2±0.77 days in the ICU compared with 5.2±0.77 days for the late group. Patients in the early group had a considerably shorter hospital stay (6.8±1.51 days) than those in the late group (10.2±1.51 days). The incidence of superficial surgical infection was 40% in the late group compared with none in the early group, and the two groups differed statistically significantly. Conclusion The nutritional status of patients with cancer who undergo major abdominal surgery greatly benefits from beginning enteral feeding early. The incidence of surgical complications decreased, and hospital and ICU stays were shortened when enteral feeding was started early.