Perioperative Enteral Supplementation and Early Postoperative Changes in Serum Proteins and Inflammatory Markers Following Colorectal Cancer Resection

Background: The early postoperative period following colorectal cancer resection is characterized by metabolic stress, protein catabolism, and systemic inflammation.Although perioperative nutritional support is increasingly recognized as an important component of surgical care, its relationship with shortterm changes in serum proteins and inflammatory markers has been less extensively investigated.Methods: This prospective, comparative study included 60 adults undergoing elective open colorectal cancer resection with primary anastomosis.The supplementation group included 30 patients who received 300 mL/day of an enteral nutritional formula for two days before and seven days after surgery, with postoperative supplementation initiated 24 hours after the procedure.Standard nutritional care without enteral supplementation was provided to the remaining 30 patients.Serum total protein, albumin, Creactive protein (CRP), and fibrinogen were assessed preoperatively and on postoperative days (PODs) 3, 5, and 7. Early postoperative morbidity was evaluated within seven days.Results: Baseline total protein, erythrocyte count, and fibrinogen were higher in the supplementation group.From baseline to POD7, mean decreases in total protein (5.07 ± 4.43 vs 9.57 ± 2.65 g/L; t(58) = 4.77, p < 0.001) and albumin (5.20 ± 4.37 vs 9.37 ± 2.74 g/L; t(58) = 4.43, p < 0.001) were smaller in the supplementation group.Mean increases in CRP (18.02 ± 18.55 vs 36.59 ± 27.87 mg/L; t(58) = -3.04,p = 0.004) and fibrinogen (0.97 ± 0.85 vs 2.67 ± 0.60 g/L; t(58) = -8.95,p < 0.001) were also smaller.Early postoperative complications occurred in two of 30 patients in the supplementation group and five of 30 patients in the standard-care group.No in-hospital deaths occurred.Conclusion: Perioperative enteral supplementation was associated with smaller early postoperative decreases in serum total protein and albumin and smaller increases in CRP and fibrinogen following colorectal cancer resection.The clinical significance of these biochemical differences remains uncertain, and the comparison of early postoperative morbidity was inconclusive.Given the study design and baseline imbalances, the findings warrant confirmation in larger, adequately controlled studies.