UFUK MALKOÇ, SEHER DEMİRER, SEMİH AYDINTUĞ, ŞERİFE ŞİMŞEK, CELALETTİN ÜSTÜN, EVRİN T GÜNGÖR, ATİLLA TÖRÜNER
Ankara Cerrahi Dergisi - 2005;7(1):12-18
This study was done to compare the effect of enteral and parenteral feeding on immune system of the patients with upper gastrointestinal tract (GIT) malignancies undergoing operation. The patients who were operated for upper GIT malignancies were randomly divided into 4 groups, each consisted of 10 patients. The patients in the first group were fed with immunonutrition, second group with standart enteral formula and third group with branched chain aminoacids, standart dextroz and lipid solutions parenteraliy until oral administration is feasible. The fourth group consisted of control group. All patients were followed up for 10 days after the surgery for postoperative septic complications. Within this period we measured the plasma IgG and IgM levels, total lymphocyte counts, B lymphocyte population, CD4/CD8 ratios, active T lymphocyte and Natural Killer (NK) cell activities and plasma interieukine-2 (IL-2) levels of the patients on the first, fourth, seventh and tenth postoperative days. There was no septic complication in the first and second group whereas there were septic complications in the third group (20%) and control group (30%) (p<0.001). The patients fed with enterally (groups 1 and 2) had significantly higher active T lymphocyte population, NK cell activity, B cell counts, serum levels of IgM and IgG and CD4/CD8 ratio than those in groups 3 and 4 within the first four days (p<0.001). Serum IL-2 levels were significantly higher in group than other groups (p<0.001). In conclusion, this study showed that enteral feeding which is begun early postoperative period inpatients with upper GIT malignancies is superior to parenteral feeding in terms of immunologic functions and prevention of septic complications.
