Journal List > Korean J Gastroenterol > v.59(6) > 1006963

Korean J Gastroenterol. 2012 Jun;59(6):407-413. Korean.
Published online June 20, 2012.
Copyright © 2012 The Korean Society of Gastroenterology
The Comparison between Early Enteral Nutrition and Total Parenteral Nutrition after Total Gastrectomy in Patients with Gastric Cancer: The Randomized Prospective Study
Hye Un Kim, Jai Bock Chung,1 and Choong Bai Kim
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to: Choong Bai Kim, Department of Surgery, Yonsei University College of Medicine, 250 Yonsei-ro, Seodaemun-gu, Seoul 120-752, Korea. Tel: +82-2-2228-2100, Fax: +82-2-313-8289, Email:
Received May 21, 2011; Revised November 29, 2011; Accepted December 04, 2011.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.



Early enteral nutrition (EEN) has benefits in reducing infectious complication, length of stay (LOS) and preserving liver function. There are few data about the effect of EEN in the patients who had total gastrectomy. The aim of this randomized and prospective study was to evaluate the effect of EEN after total gastrectomy on nutritional status, liver function, complications and LOS, compared to total parenteral nutrition (TPN) in patients with gastric cancer.


Among 56 patients with gastric cancer, 36 and 20 were randomly assigned to EEN and TPN groups, and finally 17 and 16 completed EEN and TPN schedules, respectively. The nutritional parameters, liver function, LOS and abdominal symptoms were compared between 2 groups on pre-operative day and post-operative 7th day.


There was no significant difference in the nutritional parameters, liver function between EEN and TPN groups. Vomiting and abdominal distention were more frequent in EEN than TPN group (2 vs. 0 cases, p=0.485; 1 vs. 0 case, p=1.000, respectively), while increased AST, ALT and total bilirubin were more common in TPN than EEN group (4 vs. 2 cases, p=0.398; 1 vs. 0 case, p=0.485, respectively without statistical significance). LOS was shorter in EEN than TPN group without statistical significance (12 vs. 13 days, p=0.289).


No significant differences were found in the nutritional status parameters, liver function, complications and LOS between EEN and TPN groups on 7th day after total gastrectomy. Further large scale studies on the advantages and disadvantages of EEN after total gastrectomy are warranted.

Keywords: Early enteral nutrition; Nasojejunal feeding tube; Total gastrectomy; Length of stay; Complication


Fig. 1
Selection and drop-out of patients. The early enteral nutrition (EEN) group was finally 17 patients and the total parenteral nutrition (TPN) group was 16 patients, after the drop-out with the shown causes during study period.
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Fig. 2
The changes of nutritional parameters and length of stay (LOS) in early enteral nutrition (EEN) group and total parenteral nutrition (TPN) group on postoperative 7th day. AST and ALT were increased in both groups, but triglyceride (TG), transferrin, and prealbumin were decreased in both groups. There was no significant difference in any parameters and LOS.
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Table 1
The Comparison of Anthropological and Biochemical Parameters between EEN and TPN Groups before Nutritional Support
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Table 2
Nutritional Support for EEN Group and TPN Group until Post-operative 7th Day
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Table 3
The Changes of Nutritional Parameters in Each Group after Nutritional Support on Post-operative 7th Day
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Table 4
The Comparison of Nutritional Parameters and LOS between EEN and TPN Groups after Nutritional Support on Post-operative 7th Day
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Table 5
The Comparison of Complications between EEN and TPN Groups
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Financial support: None.

Conflict of interest: None.

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