Evaluation of the efficacy of laparoscopic hepatolobectomy for primary liver cancer with early combined enteral and...

The recovery of patients with liver cancer (LC) after laparoscopic hepatolobectomy is often affected by malnutrition, low immune function, and inflammatory responses, which may lead to an increase in postoperative complications and delayed recovery. Therefore, choosing a reasonable nutritional support plan is crucial for improving the postoperative recovery of patients.

One hundred and fifty patients with primary LC who underwent laparoscopic hepatolobectomy were grouped: nutritional group (NG) and control group (CG). The NG implemented early enteral nutrition (EN) combined with parenteral nutrition (PN) support within 24 h postoperatively, while the CG only received early EN support. The liver function, nutritional indicators, plasma endotoxin levels, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) score, and postoperative recovery of the subjects were assessed.

Compared with the CG, the NG suggested visible improvement in postoperative aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and a marked increase in albumin (ALB), prealbumin (PA), and total protein (TP). In addition, the plasma endotoxin levels were visibly lower, and the postoperative time to first bowel movement was visibly shortened in the NG as against the CG. There was no statistically meaningful distinction in hospital stay, time to ambulation, and time to first flatus in the subjects. The total score of the EORTC QLQ-C30 scale in the NG was significantly higher than that in the CG after intervention (P = 0.012). The overall incidence of complications in the NG was 6.7% (5/75), which was significantly lower than the 17.3% (13/75) in the CG (P = 0.042).

Early EN combined with PN support can visibly improve the liver function and nutritional status of patients with primary LC after laparoscopic hepatolobectomy, promote postoperative immune recovery, and shorten recovery time.