Perioperative enteral immunonutrition with probiotics favors the nutritional, inflammatory, and functional statuses in digestive system surgery.

Abstract

BACKGROUND AND OBJECTIVES This study aimed to evaluate the effects of enteral immunonutrition (EIN) on the nutritional status of patients during the perioperative period of digestive system surgery. METHODS AND STUDY DESIGN The clinical data of 102 patients who underwent gastrointestinal surgery between August 2017 and February 2021 were retrospectively analyzed. According to the nutritional support regimen, the patients were divided into an enteral nutrition (EN) group (50 patients) and an EIN group (52 patients). RESULTS The times (in hours) to return of the first bowel sound, first postoperative flatus, and first bowel movement, as well as the length of postoperative hospital stay were shorter in the EIN group than in the EN group (p<0.05). The concentrations of hemoglobin, prealbumin, albumin, and transferrin, as well as the concentrations of immunoglobulin A (IgA), immunoglobulin G (IgG), immunoglobulin M (IgM), complement C3, and complement C4 were higher in the EIN group than in the EN group at 1 and 7 days after surgery (p<0.05). The concentrations of endotoxins, D-lactic acid, and diamine oxidase were lower in the EIN group than in the EN group (p<0.05). The tolerance to enteral feeding was better in the EIN group than in the EN group (p<0.05). The incidence of complications was lower in the EIN group (5.77%) than in the EN group (10.0%) (p>0.05). CONCLUSIONS EIN can promote gastrointestinal function recovery, improve the nutritional status, enhance the humoral immune function, regulate intestinal flora balance, improve intestinal permeability, prevent enteral feeding intolerance, and reduce complications in patients undergoing surgery for digestive system diseases.