Does early enteral feeding affect clinical outcome or cytokine profiles after elective surgery for colorectal cancer?

Patients who have intestinal cancer are prone to malnutrition, which can result in deterioration of physiological function, poor wound healing, increased risk of infection and prolonged hospital stay. These complications are particularly relevant after colorectal surgery. Early enteral feeding, to enhance nutritional status, has been reported to reduce post-operative complications, length of hospital stay and morbidity and mortality after upper gastro-intestinal cancer surgery. Inflammatory cytokines (IL-6, TNF-a (a)), clinical outcomes and postoperative complications were measured in 147 patients undergoing elective surgery for colorectal cancer (84 standard care; 64 patients had early enteral feeding in addition). There were no significant differences in age, length of operation, complication rate or days to discharge between the two groups. IL-6 levels peaked on POD-1 in both groups. TNF-a levels gradually increased from the pre-operative sample to POD-7. In both groups cytokine levels correlated significantly with complications (P < 0.05, Spearman's correlation). Post-operative plasma levels of the inflammatory cytokines correlated with the occurrence and severity of surgical complications after elective colorectal surgery. Early enteral nutrition was not associated with increased post-operative complications nor was it related to any change in cytokine profiles.