Early oral feeding versus traditional feeding after transanal endorectal pull-through procedure in Hirschsprung's disease

Abstract

Our study questioned whether the outcome of postoperative early oral feeding is different from traditional postoperative feeding in children with Hirschsprung's disease who underwent transanal endorectal pull-through.This was an observational and comparative study. Patients were allocated into 2 groups. Age, gender, fever, surgery-related infectious, abdominal distension, bowel obstruction, need for reoperation, peritonitis, anastomosis leak, and abscess formation were assessed. IV fluids and antibiotics usage were recorded. A Chi-square test, independent sample unpaired Student t test and Mann–Whitney test were used. P-value < .05 was considered statistically significant.Infections occurred in no patient in group 1 and 1 patient in group 2. Stenosis occurred in 3 patients in group 1 and 2 patients in group 2. Abdominal distension occurred in 4 patients in group 1 and 3 patients in group 2. Fever occurred in 2 patients in group 1 and 1 patient in group 2 within the first 24 hours and it occurred in 13 and 17 patients, respectively, within 48 hours. All patients of group 1 (n = 15) were treated with antibiotics and intravenous fluid administration; 1 patient for 24 hours, 12 patients for 48 hours, and 1 for 72 hours, respectively. All patients of group 2 (n = 18) were treated with antibiotics and intravenous fluid administration for 5 days. We noted a significant difference regarding the duration of antibiotic treatment and intravenous fluid administration after 72 hours.This study showed that there was no difference between the outcomes of early and traditional postoperative feeding. Due to a significant difference in the antibiotics and IV fluid administration intervals between these 2 groups which cause a prolonged hospital stay and higher costs, it seems that early postoperative feeding is superior to traditional strategy.

Comparison Outcome of Patients with Rectal Tube and Without Rectal Tube Post Swenson Like Pull-Through Transanal Procedure at RSUP Prof Dr. I G.N.G. Ngoerah

“…The incidence of obstruction was found to be 0%, while that of non-obstruction was 100%. Research Ashjaei et al ( 2019) found the incidence of obstruction was absent, but complaints of abdominal distension were obtained as much as 27%, but statistically, there was no difference [37].…”

“…Research by Ashjaei et al (2019) found the incidence of infection, stenosis, abdominal distension, and fever can occur in Soave and Swenson techniques, but statistically, there is no difference between the two techniques in early feeding on the incidence of stenosis and abdominal distension [37].…”

Systematic Review of Definitions and Outcome Measures for Postoperative Ileus and Return of Bowel Function after Abdominal Surgery in Children

“…In 18 articles, postoperative ileus was mentioned as an outcome, a definition was provided in eight articles (►Table 3). 14,15,26,27,32,43,46,50,53,57,60,65,67,69,71,72,75,79 One of the articles providing a definition did not report accompanying outcome measures. 57 Of the eight provided definitions, four specified the timeframe of their definition.…”