The impact of early nutritional care intervention on gastrointestinal function, immune function and nutritional indicators in patients after radical surgery for esophageal cancer: A single-center, observational study

This study aims to evaluate whether initiating naso-jejunal enteral nutrition within 24 hours after radical esophagectomy shortens the time to first bowel sound, first oral intake, and first defecation. It also investigates whether it improves early postoperative nutritional markers without adversely affecting albumin levels, and whether it enhances cellular immunity, thereby mediating the impact of protein intake on gastrointestinal recovery. A total of 90 patients undergoing radical esophageal cancer surgery at The Fourth Hospital of Hebei Medical University from January 2019 to June 2021 were randomly divided into 2 groups: intervention (n = 45) and control (n = 45). The control group received routine postoperative care, while the intervention group received early nutritional therapy combined with comprehensive nursing interventions. Key indicators, including gastrointestinal function recovery, nutritional status (transferrin, prealbumin, and albumin levels), immune function (CD4+, CD8+, and CD4+/CD8 + ratios), and complications, were monitored and analyzed. Quantitative analysis demonstrated that the intervention shortened mean time to first bowel sound by 1.26 days (2.07 ± 0.77 vs 3.33 ± 0.98 days), to first oral intake by 1.28 days (2.76 ± 0.79 vs 4.04 ± 0.74 days) and to first defecation by 1.54 days (3.24 ± 0.74 vs 4.78 ± 0.60 days); all P < .001. Post-care transferrin rose by 1.42 g/L (33.28 ± 4.31 vs 31.86 ± 3.38 g/L) and pre-albumin by 0.76 mg/dL (46.30 ± 4.16 vs 45.54 ± 4.17 mg/dL), while albumin remained unchanged (P = .865). CD4 + counts increased by 4.16 %, CD8 + counts decreased by 4.63 %, and the CD4+/CD8 + ratio improved by 0.22 (2.00 ± 0.26 vs 1.78 ± 0.16, P = .004). The CD4+/CD8 + ratio mediated 9.1 % of the effect of protein intake on defecation time. The incidence of complications was lower in the intervention group (P < .05). Early enteral nutritional support combined with comprehensive nursing interventions significantly improves quantifiable clinical, nutritional, and immune outcomes, accelerating gastrointestinal recovery and underscoring the value of integrating targeted nutritional support into postoperative care.