Effects of Early Enteral Nutrition After Total Gastrectomy for Gastric Cancer

Objective. To evaluate the effectiveness of correction of protein and energy deficiency after total gastrectomy for stomach cancer with domestic special metabolic enteral mixtures with detoxification and restorative focus LEOVIT ONCO, as well as to analyze the effect of correction on postoperative period. Material and methods. A prospective randomized trial included 100 cancer patients who underwent total gastrectomy. They were divided into two groups by 50 people each. Patients in the main group took domestic enteral nutrition with LEOVIT ONCO, in the control group — imported enteral nutrition. The total course of enteral nutrition was 12 days (3 days before surgery and day 2—10 after surgery). Anamnestic data, anthropometric and laboratory parameters were studied before surgery, 2—3 days and 10—12 days after surgery. Non-parametric methods were used for analysis (Fisher’s exact test for qualitative data, Mann-Whitney test for quantitative data). Results. Domestic enteral nutrition with detoxification and restorative orientation increased serum total protein, albumin, hemoglobin and erythrocyte count after 10—12 postoperative days by 18.8%, 13.8%, 10.9% and 15.2%, respectively. Imported nutrition decreased total protein by 2.8%, increased albumin, hemoglobin and erythrocyte count by 7.5%, 1.7%, and 5.2%, respectively. Domestic enteral nutrition reduced postoperative hospital-stay by 1.38 times, postoperative morbidity by 1.33 times, time to gas discharge by 2.5 times and time to the first bowel movement by 1.7 times compared to appropriate values in the control group. Domestic enteral nutrition increased skin-fat fold thickness and shoulder circumference by 1 cm compared to baseline values, whereas the control group had no changes. LEOVIT ONCO nutrition did not cause intolerance or allergic reactions. Patients did not refuse to take it and drank the whole portion. Conclusion. This study demonstrates comparable and in some key indicators higher clinical and economic efficiency of domestic enteral nutrition products in perioperative period for cancer patients with nutritional disorders. This may be explained by minor biologically active substances in domestic nutrition improving not only protein absorption in the body, but also metabolic and detoxification processes.