Efficiency of a semi-elemental mixture as part of complex therapy for chronic diarrhea in patients with gastric cancer after completion of treatment

Vollständiger Abstract

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BACKGROUND: Radical antitumor treatment for gastric cancer (GC) can lead to chronic diarrhea. Therefore, the choice of enteral formula for nutritional support becomes important. AIM: To compare the effectiveness of using semi-elemental and standard polymer mixtures in the post discharge period in patients after gastrectomy. METHODS: A retrospective, non-randomized, single-center study included patients with gastric cancer over 18 years old after gastrectomy, completed anticancer treatment, had no progression of the cancer, and had chronic diarrhea. At the initial consultation, patients received dietary advices, as well as recommendations for probiotics, polyenzyme preparations, and sipping (500 ml per day) of semi-elemental or polymeric mixtures at the patient's discretion. After 28 days, the patients were divided into 2 groups depending on the type of mixture they chose. The study group (SG) had patients receiving the semi-elemental mixture, the control group (CG) had patients receiving polymeric mixtures. The dynamics of diarrhea, nutritional and functional status indicators were analyzed. Statistical data processing was performed using the appropriate software package Microsoft Excel 2011. The results are presented as the mean value ± standard deviation. To assess statistical differences, a two-tailed Student's t-test was used. RESULTS: A total of 113 patients with GC (65 men) were examined. Fifty-five patients took the semi-elemental mixture, and 58 people took various polymer mixtures. After treatment the frequency of defecation was significantly lower in the SG than in the CG (2.05±1.43 vs 2.61±1.46 times, p=0.04). In the SG, body weight, serum concentration of total protein, absolute lymphocyte count were higher than in the CG: 64.23±10.33 vs 63.56±8.6 kg; 68.61±2.37 vs 67.78±4.46 g/l; 2.33±0.4 vs 2.15±0.43*10^9/l, p0.05, respectively. ECOG’s functional status, hand muscle grip, level of anxiety and depression were better in the SG (0.89±0.6 vs 1.17±0.75 points, 33.51±10.09 vs 29.66±9.58 kg, 6.44±1.24 vs 7.09±1.61 points, 8.27±1.62 vs 8.86±1.3 points, p0.05, respectively). CONCLUSION: In GC patients after antitumor treatment, the use of a semi-elemental enteral mixture as additional nutrition had advantages over standard polymer mixtures.