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Effects of Lipid Emulsions in Parenteral Nutrition of Esophageal Cancer Surgical Patients Receiving Enteral Nutrition: A Comparative Analysis
Department of Thoracic Surgery, Tangdu Hospital, The Fourth Military Medical University, No.1, Xinsi road, Xi'an 710038, China
Department of Thoracic Surgery, Cancer Center of Sun Yat-Sen University, State Key Laboratory in Southern China, No. 651, Dongfeng Donglu, Guangzhou 510060, China
These authors contributed equally to this study.
* Authors to whom correspondence should be addressed.
Received: 14 November 2013; in revised form: 8 December 2013 / Accepted: 10 December 2013 / Published: 27 December 2013
Abstract: Background: Olive oil-based lipid emulsion (LE) and medium chain triglyceride/long chain triglyceride (MCT/LCT) emulsion are both LEs with low ω-6 polyunsaturated fat acids (PUFAs) content. However, which one of these LEs is associated with a lower infection risk in patients receiving parenteral nutrition (PN) remains unclear. The aim of the study was to compare the effects of the two LEs in PN in esophageal cancer patients undergoing surgery. Methods: Patients with resectable esophageal carcinoma were recruited and allocated randomly to two groups. The test group was given enteral nutrition (EN) with PN containing olive oil-based LE after tumor resection for ≥7 days, and the patients in the control group were supported by EN with MCT/LCT emulsion-based PN after surgery for the same time period. Immunological markers and inflammatory indicators were tested and perioperative clinical outcomes were determined. The trial was registered in the Chinese Clinical Trial Register, number ChiCTR-TRC-13003562. 94 Patients were recruited, and grouped (olive oil-based LE, n = 46 and MCT/LCT, n = 48), matched for sex, age, body mass index, histological type, TNM stage, and nutrition risk screening (NRS) 2002 score. Results: There were no differences in perioperative fever (>38 °C), infectious complications, length of hospital stay (>14 days), length of critical care stay (>2 days), time for oral food intake, and in-hospital mortality between the two groups. The test group showed a higher increase in IgG level compared with the MCT/LCT group (p = 0.028). There was no difference in other immunological markers and inflammatory indicators between the two groups. Conclusion: PN containing olive oil-based or MCT/LCT LEs had similar effects on perioperative outcome, cell-mediated immune function and inflammatory response in esophageal cancer patients who had undergone surgery and were receiving EN.
Keywords: enteral nutrition; parenteral nutrition; olive oil; lipid emulsion; medium-chain triglyceride; long-chain triglyceride; immune function; esophageal cancer
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Wang, W.-P.; Yan, X.-L.; Ni, Y.-F.; Guo, K.; Ke, C.-K.; Cheng, Q.-S.; Lu, Q.; Zhang, L.-J.; Li, X.-F. Effects of Lipid Emulsions in Parenteral Nutrition of Esophageal Cancer Surgical Patients Receiving Enteral Nutrition: A Comparative Analysis. Nutrients 2014, 6, 111-123.
Wang W-P, Yan X-L, Ni Y-F, Guo K, Ke C-K, Cheng Q-S, Lu Q, Zhang L-J, Li X-F. Effects of Lipid Emulsions in Parenteral Nutrition of Esophageal Cancer Surgical Patients Receiving Enteral Nutrition: A Comparative Analysis. Nutrients. 2014; 6(1):111-123.
Wang, Wu-Ping; Yan, Xiao-Long; Ni, Yun-Feng; Guo, Kang; Ke, Chang-Kang; Cheng, Qing-Shu; Lu, Qiang; Zhang, Lan-Jun; Li, Xiao-Fei. 2014. "Effects of Lipid Emulsions in Parenteral Nutrition of Esophageal Cancer Surgical Patients Receiving Enteral Nutrition: A Comparative Analysis." Nutrients 6, no. 1: 111-123.