Comparative study between early versus late enteral nutrition after gastrointestinal anastomosis operations

Abstract

Introduction An anastomosis of the digestive tract is a common operation, whether it be an unexpected medical crisis or a planned procedure. Feeding soon after gastrointestinal anastomosis is not only physiological, but also protects against morphologic and functional trauma-related modifications in the gut. Aim of work This research aimed to evaluate the advantages and disadvantages of initiating Enteral Nutrition immediately following gastrointestinal anastomosis surgery versus delaying it for a later time. Additionally, the frequency of Adverse Events. Patients and methods Thirty patients underwent abdominal surgery, with treatments ranging from small- to large-intestine anastomosis, for both urgent and elective reasons. Early postoperative enteral feeding in the early feeding group commenced within 24 h of surgery or immediately following nasogastric tube removal. The delayed feeding group began enteral feeding using the standard technique once bowel sounds were restored, distention was gone, and the patient passed flatus or stool. 14 patients were in the early enteral feeding group (A) while 16 patients were in the late enteral feeding group (B). Data regarding blood loss and transfusion, NGT removal time, time of intestinal sounds return, time of passage flatus and stool, hospital stay and postoperative complications were recorded. Results Among those who ate too early (46.6%), those who ate late (53.3%), abdominal distension was noted in 28.6%,in the early group and 43.8% in late feeding group and vomiting was reported in 50.0%, and 62.5%, respectively. In the first group, 57.1% of those who fed early experienced fever, while in the second group, 75.0% of those who fed late did so. Late feeding is associated with a statistically significant rise in both the Day of NGT removal and the Length of stay. When patients were admitted for early feeding, they stayed in the hospital for an average of 5.71 days. There was no statistically significant difference according serum albumin between the early feeding (3.79) and late feeding (3.50). There was a significantly higher concentration of potassium in the blood in the early feeding group (3.93) compared to the late feeding group (3.219). Anastomotic leaking, surgical site infection, and intensive care unit admission were not significantly different between early and late feeding. Conclusion Early enteral feeding has the upper hand on late enteral feeding as it goes with GIT physiology, we found that early postoperative feeding following gastrointestinal anastomosis surgery significantly reduced the day of NGT removal and the length of hospitalization, which may be attributable to fewer problems and better gut motility and healing.