Original Articles
Effect of intraoperative methylprednisolone in combination with perioperative enteral nutrition support on recovery after hepatectomy
Xuejian Zi, Hui Yao, Yudong Qiu, Xiao Fu, Liang Mao, Tie Zhou, Chaobo Chen
Published 2015-04-30
Cite as Chinese Journal of Clinical Nutrition, 2015, 23(2): 89-94. DOI: 10.3760/cma.j.issn.1674-635X.2015.02.005
Abstract
ObjectiveTo investigate the clinical efficacy of intraoperative methylprednisolone used in combination with perioperative enteral nutrition support in improving liver synthetic function after hepatectomy and postoperative recovery.
MethodsIn this prospective controlled trial, 79 patients treated with hepatectomy at Departement of Hepatobiliary Pancreatic Surgery in Drum Tower Hospital between June 2013 and May 2014 were included and divided into control group (n=39) and steroid group (n=40) according to the order of surgery. The control group underwent hepatectomy only, while the steroid group received intraoperative methylprednisolone (500 mg) at the start of liver excision. Both of the two groups were given the same perioperative enteral nutrition support. Liver function, prealbumin (PA), and C-reactive protein (CRP) levels were measured before and on days 1, 3, and 5 after the operation. Human blood albumin infusion volume, postoperative gas passing, postoperative hospital stay, and incidence of complications were recorded.
ResultsThe serum level of PA on day 3 after hepatectomy was significantly higher in the steroid group than in the control group [(101.26±61.17) mg/L vs. (81.84±43.58) mg/L, t=-1.607, P=0.049]. The serum level of cholinesterase on day 1 after hepatectomy was significantly higher in the steroid group than in the control group [(5.60±1.54) kU/L vs. (4.68±1.01) kU/L, t=-3.136, P=0.004]. On day 1 and day 3 after hepatectomy, the serum levels of CRP were significantly lower in the steroid group than in the control group [(41.79±20.86) mg/L vs. (62.08±38.33) mg/L, t=2.933, P=0.027; (64.14±32.38) mg/L vs. (102.64±49.05) mg/L, t=4.127, P=0.006]. The postoperative hospital stay was significantly shorter in the steroid group than in the control group [(12.62±5.74)d vs. (15.41±10.00)d, t=1.514, P=0.002].
ConclusionIntraoperative use of methylprednisolone combined with perioperative enteral nutrition support may inhibit postoperative inflammatory response, promote early recovery of liver synthetic function, and help to promote rehabilitation after hepatectomy.
Key words:
Liver resection; Enteral nutrition; Methylprednisolone; Liver function
Contributor Information
Xuejian Zi
Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing 210000, China
Hui Yao
Yudong Qiu
Xiao Fu
Liang Mao
Tie Zhou
Chaobo Chen