Abstract

Objective: We aimed to investigate the effects of enteral immunonutrition and Total Parenteral Nutrition (TPN) on the immune system and acute inflammatory response of patients who underwent major abdominal surgery.

Material and Methods: Sixty gastric or colorectal cancer patients were randomized into two groups. Enteral immunonutrition was given to the first group and TPN was given to the second group. Albumin, prealbumin, retinol binding globulin (RBP), transferrin, IL-2, IL-6, CRP and T-Lymphocyte levels were determined for nutritional state and immunologic evaluation. Also, postoperative complications, postoperative intensive care unit (ICU) and hospital stays were compared between the two groups.

Results: All nutritional parameters were significantly decreased on the postoperative first day in both groups. RBP and prealbumin levels significantly increased in Group I on postoperative day 5. IL-6 and CRP levels increased significantly in both groups. IL-2 levels increased significantly in Group I, T-lymphocyte percentage decreased significantly in Group II on postoperative day 1 and 5. The length of ICU and hospital stays were longer and postoperative infection rate was less in Group II.

Conclusion: Decrease in severity of acute inflammatory response and postoperative infection rate, augmentation in cellular immunity, decrease in the length of ICU and hospital stay were observed in the enteral immunonutrition group after major abdominal surgery.