Efficacy of four weeks of home enteral feeding supplementation after esophagectomy on immune function: a randomized controlled trial.

Abstract Introduction : Home enteral nutrition (HEN) was adopted as a feasible and safe way which might be beneficial to patients undergoing esophagectomy in recent years. The aim of this study was to compare the effects of four weeks home enteral nutrition with standard enteral nutrition on immune function, nutritional status and survival in patients undergoing esophagectomy. Methods : A parallel-group, randomized, single-blind, clinical trial was conducted between April 1, 2017 and August 1, 2017. Eighty patients were enrolled in this study and 62 patients were eligible for analysis. An enteral feeding pump was used to infuse enteral nutrition via jejunostomy tube postoperatively. Patients in HEN group were instructed to independently administer jejunostomy feeds at home. Immune parameters and nutritional indicators were measured at preoperative day 7 and at postoperative day 30. Results : There were no significant differences in baseline characteristics between the two groups. The levels of IgA and IgG which can reflect the patients’ immune function significantly increased in HEN group compared with SEN group (P = 0.042 and P = 0.003, respectively). Comparing the two groups, 2-year progression-free survival and overall survival had no significant differences in survival curves (P = 0.36 and P = 0.29, respectively). Conclusion : Four weeks home enteral nutrition is a safe and feasible nutritional strategy to improve immune function and nutritional status after esophagectomy. Although there was no significant difference in survival between the two groups, home enteral nutrition could still be more effective and beneficial to patients with defective nutritional and immune status than standard enteral nutrition.