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Evaluation of perioperative correction of nutritional deficiency in patients with complicated forms of esophageal and gastric cancer

Khirurgiia (Mosk). 2025;(6):78-88. doi: 10.17116/hirurgia202506178.

ABSTRACT

OBJECTIVE: To confirm the possibility of correcting protein-energy malnutrition in patients suffering from esophageal and gastric cancer using a new type of domestic enteral nutrition with a metabolic focus, such as DETOX, and to analyze the effect of correction of disorders on the course of the postoperative period.

MATERIAL AND METHODS: A total of 70 patients suffering from esophageal and gastric cancer were selected for participation in the study using the open randomization method and divided into two groups of 35 people. Patients of the first group took domestic enteral nutrition LEOVIT ONCO, patients of the second group took imported enteral nutrition. Anthropometric indicators, laboratory and questionnaire data were assessed: during the initial consultation, before admission to the hospital — 14 days before hospitalization, immediately upon hospitalization, before surgery, in the first three days after surgery, before discharge. Data collection and processing was carried out by the staff of the Department of Faculty Surgery No. 2 named after G.I. Lukomsky based on the University Clinical Hospital No. 4 of Sechenov University. Statistical analysis was performed using the StatTech v. 4.6.3 program (developer — StatTech LLC, Russia).

RESULTS: Domestic detoxifying enteral nutrition ensures normalization of body weight, an increase in the level of total protein, albumin and transferrin in the blood of patients before discharge by 15.3%, 16.4% and 74%, respectively, compared with the initial level, while imported nutrition contributed to a less pronounced increase in these indicators — by 11.8%, 9.6% and 48%, respectively. Despite the fact that both groups managed to achieve the desired level of total protein, albumin, in the LEOVIT ONCO group we needed less effort in terms of parenteral nutrition, enzymatic correction of profuse diarrhea, manifested with a significant decrease in the BCC, additional infusions of albumin and amino acids, especially in patients with a BMI <18. Unlike patients taking imported enteral nutrition, in patients on the background of LEOVIT ONCO therapeutic nutrition, immune-inflammatory markers (NLR, MLR, PLR) normalized, diarrhea of the «cholera» type was stopped, bowel movements occurred regularly, the amount of feces was moderate, they had a soft consistency and a formed appearance, and there was also no intestinal paresis. LEOVIT ONCO therapeutic nutrition did not cause intolerance or allergic reactions, patients did not refuse to take it and drank the entire portion.

CONCLUSION: This study of domestic and imported drugs for enteral nutrition demonstrates comparable, and in some key indicators, higher clinical and economic efficiency of domestic enteral nutrition products in the perioperative period in cancer patients with nutritional status disorders.

PMID:40455023 | DOI:10.17116/hirurgia202506178