Does disorder of gastrointestinal motility affect food intake in the post-surgical patient?

Bowling, Tim

doi:10.1079/pns19940018

Cited by 28 publications

(10 citation statements)

References 33 publications

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“…Contrary to the widespread belief, various studies have confirmed the safety and feasibility of early oral feeding (EOF) (6, 7, 10–13). A randomized clinical trial performed by Hur et al demonstrated that EOF was feasible, and could result in shorter hospitalization and improvements in the quality of life of 54 patients receiving open gastrectomy (7).…”

Section: Introductionmentioning

confidence: 98%

“…Traditionally, oral feeding is delayed after gastric surgery, until the passage of flatus, or appearance of audible bowel sounds or bowel movements due to the theoretical concerns of increased risk of anastomosis leakage (5). The rationale of nil by mouth was to allow the anastomosis to heal before being stressed by food (6). However, recent studies have questioned this traditional concept of fasting until passage of flatus after gastric surgery (7–9).…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Early Oral Feeding With Traditional Oral Feeding After Total Gastrectomy for Gastric Cancer: A Propensity Score Matching Analysis

et al. 2019

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Background: The present study aimed to compare the feasibility and safety of early oral feeding (EOF) with traditional oral feeding (TOF) after radical total gastrectomy for gastric cancer.Methods: This retrospective study included consecutive patients who underwent total gastrectomy from April 2016 and November 2018. These patients were divided into two groups, according to their postoperative feeding protocol: EOF group (n = 314) and TOF group (n = 433). Propensity score matching was used to balance the potential confounders, and 276 patients were selected from each group. The EOF group received oral diet on postoperative day one, while the TOF group were started on oral feeding after the passage of flatus.Results: No significant differences were found in the postoperative complications (P = 0.426) and tolerance to oral feeding (P > 0.056) between the two groups. The changes in perioperative nutritional markers were also similar between the two groups (P > 0.05). The time to first passage of flatus or defecation (47.19 ± 12.00 h vs. 58.19 ± 9.89 h, P < 0.0001) and length of postoperative hospital stay (6.84 ± 2.31 days vs. 7.72 ± 2.86 days, P < 0.0001) were significantly lower in the EOF group compared to the TOF group.Conclusion: EOF may be safe and feasible after radical total gastrectomy with faster recovery and no increased risk of postoperative complications.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Comparison of Early Oral Feeding With Traditional Oral Feeding After Total Gastrectomy for Gastric Cancer: A Propensity Score Matching Analysis

et al. 2019

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“…Nutritional support is crucial after gastric surgery. Due to the protection of the anastomotic site and potential transient ileus [9], a fasting period with only parenteral nutrition after gastric surgery until bowel function is clinically detectable is routine [10]. Nevertheless, parenteral nutrition as the only nutritional route has greater nutritional and immunological disadvantages than enteral nutritional support [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Safety of early oral feeding after total laparoscopic radical gastrectomy for gastric cancer (SOFTLY): Study protocol for a randomized controlled trial

Wang

Guo

Zhao

et al. 2019

Trials

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Background Gastric cancer is the third most common cause of cancer-related deaths and has the fifth highest incidence worldwide, especially in eastern Asia, central and Eastern Europe, and South America. Currently, surgery is the only curative treatment for gastric cancer; however, there is an increasing trend toward laparoscopic radical gastrectomy. Early oral feeding (EOF) has been shown to benefit clinical outcomes compared with open gastrectomy under conditions of enhanced recovery after surgery. There are a lack of guidelines and evidence for the safety and feasibility of EOF in patients undergoing laparoscopic radical gastrectomy. Thus, a prospective randomized trial is warranted. Methods/design The EOF after total laparoscopic radical gastrectomy (SOFTLY) study is a single-center, parallel-arm, non-inferiority randomized controlled trial which will enroll 200 patients who are pathologically diagnosed with gastric cancer and undergo laparoscopic radical gastrectomy. The primary endpoint, incidence of anastomotic leakage, is based on 1.9% in the control group in the CLASS-01 study. The patients will be randomized (1:1) into two groups: the EOF group will receive a clear liquid diet on post-operative day 1 (POD1) and the delayed oral feeding (DOF) group will receive a clear liquid diet on post-operative day 4 (POD4). The demographic and pathologic characteristics will be recorded. Total and oral nutritional intake, general data, total serum protein, serum albumin, blood glucose, and temperature will be recorded before surgery and at the time of hospitalization. Adverse events will also be recorded. The occurrence of post-operative fistulas, including anastomotic leakage, will be recorded as the main severe post-operative adverse event and represent the primary endpoint. Discussion The safety and feasibility of EOF after gastrectomy has not been established. The SOFTLY trial will be the first randomized controlled trial involving total laparoscopic radical gastrectomy, in which the EOF group (POD1) will be compared with the DOF group (POD4). The results of the SOFTLY trial will provide data on the safety and feasibility of EOF after total laparoscopic radical gastrectomy. Trial registration Chinese Clinical Trial Registry, ChiCTR-IOR-15007660 . Registered on 28 December 2015. The study has full ethical and institutional approval. Electronic supplementary material The online version of this article (10.1186/s13063-019-3493-2) contains supplementary material, which is available to authorized users.

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“…The possibility exists, however, that some significant findings found in the present series of cholecystectomized patients could be partly due to cholecystectomy itself involving neuro‐hormonal and anatomic changes. Post‐operative ileus, for example, is a predictable, self‐terminating event, occurring after most general anaesthetic procedures . However, cholecystectomy might induce effects in the medium‐ and long‐term period but studies are somewhat heterogeneous.…”

Section: Discussionmentioning

confidence: 99%

“…Post-operative ileus, for example, is a predictable, self-terminating event, occurring after most general anaesthetic procedures. 42 However, cholecystectomy might induce effects in the medium-and long-term period but studies are somewhat heterogeneous. Symptoms of postcholecystectomy syndrome are likely not related to increased duodenogastric reflux after surgery.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal defects in gallstone and cholecystectomized patients

Ciaula

Molina-Molina

Bonfrate

et al. 2019

Eur J Clin Investigation

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Background and aim Several gallstone patients complain of dyspeptic symptoms, irrespective of the presence of typical colicky pain. Symptoms often persist after a cholecystectomy. Systematic studies on dyspepsia and dynamic gastrointestinal motor function are missing in gallstone patients with preserved gallbladder or after a cholecystectomy. Materials and methods Forty‐six gallstone patients (age 55 ± 2 years; 15M, 31F) and 24 cholecystectomized patients (age 57 ± 2 years; 6M, 18F) (no difference in type and volume of gallstones between the two groups) were compared against a group of 65 healthy controls (age 51 ± 2 years; 30M, 35F). Dyspepsia occurring in the prior months was assessed by a questionnaire, gastric and gallbladder emptying by functional ultrasonography and orocecal transit time by a hydrogen breath test using a lactulose‐enriched standard liquid meal. Results Gallstone patients had significantly greater dyspepsia, fasting and residual gallbladder volumes, and slower gallbladder emptying, gastric emptying and small intestinal transit time than controls. In cholecystectomized patients, gastric emptying further delayed, compared to gallstone patients and controls. Conclusion Gallstone patients with the gallbladder “in situ” or after a cholecystectomy display dyspeptic symptoms. Symptoms are associated with multiple gastrointestinal motility defects involving the gallbladder, stomach and small intestine. After cholecystectomy, gastric emptying worsens.

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Does disorder of gastrointestinal motility affect food intake in the post-surgical patient?

Cited by 28 publications

References 33 publications

Comparison of Early Oral Feeding With Traditional Oral Feeding After Total Gastrectomy for Gastric Cancer: A Propensity Score Matching Analysis

Comparison of Early Oral Feeding With Traditional Oral Feeding After Total Gastrectomy for Gastric Cancer: A Propensity Score Matching Analysis

Safety of early oral feeding after total laparoscopic radical gastrectomy for gastric cancer (SOFTLY): Study protocol for a randomized controlled trial

Gastrointestinal defects in gallstone and cholecystectomized patients

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