Early Postoperative Feeding Could Partially Replete Plasma Glutamine and Arginine Following Resection of Colorectal Cancer

The purpose of the study are: (1) To assess the relative changes of plasma glutamine and arginine levels following surgical stress, and (2) to compare the effects of early feeding methods on the restoration of glutamine and arginine.One hundred and forty patients underwent colon resection for cancer entered the study. Group I patients were kept on nothing per os (NPO) for 6 days. Group II, III, IV were fed through a nasogastric (NG) tubes, and group V, VI, VII were fed through a nasojejunal (NJ) tubes from the second to the sixth postoperative day (POD) with low residual, high-fat and glutamine-containing enteral formulas. The patients had measurement of plasma glutamine and arginine preoperatively, on the first and the sixth postoperative day.Both plasma glutamine and arginine decreased following surgery in all groups of patients. Glutamine and arginine were surprisingly higher than the preoperative level on the sixth POD in NPO group. Glutamine and arginine were relatively restored with early tube feeding.In conclusion, the study suggested that plasma glutamine and arginine were decreased following surgery, but starvation will probably mobilize the glutamine and arginine reserve in the body. Early feeding could at least partially replete glutamine and arginine.