Background: This study aims to determine the effect of glutamine-enforced parenteral nutrition on immune function and stress response of patients after esophageal operation.

Methods: A total of 143 esophageal cancer patients (71 males, 72 females; mean age 70.7±4.3 years; range 35 to 80 years) undergoing the same elective operation were randomized into two groups as the experimental group which was given additional alanyl-glutamine (0.35 g/kg/day glutamine) and the control group which was performed simple vein injection. All patients were infused with equal calorie and nitrogen by central vein during the postoperative seven days. Patients’ immunological and inflammatory parameters were analyzed.

Results: Preoperatively, the levels of immunoglobulin A, G, M levels, CD3+ and CD4+ T lymphocytes, and CD4+/CD8+ T lymphocytes ratio of both groups were lower than normal values. The levels of complement 3 (C3), C4 and C reactive protein of both groups were higher than normal values. On the first postoperative day, all indicators of experimental group were superior to the control group except for levels of C reactive protein, immunoglobulin M, and CD3+ and CD8+ cells (p>0.05). On the seventh postoperative day, the C reactive protein level of experimental group was lower than that of control group (p<0.05), while the CD4+ cells, immunoglobulin A and G levels of experimental group were higher than the control group (p<0.05).

Conclusion: Compared with conventional parenteral nutrition, glutamine-enforced parenteral nutrition support may significantly improve the immune function and reduce stress response in patients after esophageal operation.

Keywords : Esophageal cancer; glutamine; parenteral nutrition