LAUSR

Malnutrition is frequent in esophageal cancer patients and aggravated by operation, increasing postoperative complications and mortality. Although a preoperative immunonutrition pharmaceutics diet significantly reduced the incidence of postoperative infectious complications, the effect of perioperative immunonutrition of esophagectomy for esophageal cancer still remains unclear. This study design was a prospective randomized study. 40 patients with thoracic esophageal carcinoma who underwent esophagectomy were divided into two groups. Continiously 7 days before and after surgery, they enrolled and received either immunomodulating enteral nutrition (IMPACT® Group: IG) or standard enteral nutrition (Ensure® Group: EG). The nutrition statement, postoperative ICU stay, postoperative hospital stay, morbidity and mortality were investigated prospectively. There was no difference of patient demographics between two groups. Retinol-binding protein as rapid turnover protein was significantly higher on postoperative day (POD) -1, POD 7 and POD 14 in the IG than in the EG (P = 0.009, P = 0.004 and P = 0.024, respectively). The incidence of postoperative infectious complications and changes to therapeutic antibiotics was significantly lower in the IG than in the EG (P = 0.048 and P = 0.012, respectively). No difference was observed in postoperative ICU stay and postoperative hospital stay between two groups. The 5-year PFS in the IG and EG groups were 75% and 64% (P = 0.188), respectively, and OS were 68% and 55% (P = 0.187), respectively. This study showed that immunonutrition would be effective to improve the early nutritional status and reduce postoperative infectious complications. All authors have declared no conflicts of interest.