Effects of Early Enteral Nutrition on Patients After Emergency Gastrointestinal Surgery

Lee, Seung Hwan; Jang, Ji Young; Kim, HyungWon; Jung, Myung Jae; Lee, Jae-Gil

doi:10.1097/md.0000000000000323

Cited by 37 publications

(28 citation statements)

References 22 publications

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“…[1–5] It has been described that intestinal edema could contribute to the detrimental effect on intestinal function, which is associated with increased septic complications. Intestinal edema is related to early ileus, which could postpone the initiation of enteral feeding.…”

Section: Introductionmentioning

confidence: 99%

Impact of hypertonic saline on postoperative complications for patients undergoing upper gastrointestinal surgery

et al. 2017

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The aim of this study was to explore the impact of 3% hypertonic saline (HS) intragastric administration for patients who underwent upper gastrointestinal surgery.During the postoperative period, 3% HS has been suggested as a means to improve the intestinal edema and reduce gastrointestinal complications.The medical records of 111 patients with HS intragastric administration following upper gastrointestinal surgery and 268 patients, served as control, were reviewed retrospectively. Propensity score matching was performed to adjust for selected baseline variables. Clinical outcomes, including early gastrointestinal function recovery, postoperative complications, and length of hospital stay, were compared according to the HS intragastric administration or not.HS intragastric administration was associated with prompt postoperative gastrointestinal function recovery, including first flatus (risk ratio [RR], 1.32; 95% confidence interval [CI], 0.89–1.65; P = 0.048) and feeding within 3 postoperative days (RR (95% CI), 0.57 (0.49–0.77); P = 0.036). Early ileus occurred in 25 of 108 patients with HS treatment versus 36 of 108 patients without HS treatment (RR (95% CI), 1.43 (0.63–2.15); P = 0.065). The patients with HS experienced a lower overall postoperative complication (odds ratio [OD] 0.57; 95% CI, 0.33–1.09; P = 0.063), including trend toward a decrease for infectious complications (15[13.9] vs 23[21.3]; P = 0.11; OD, 0.59; 95% CI, 0.29–1.22). There was a decreased incidence of anastomotic leakage (1[0.9] vs 7[6.5]; P = 0.033) and postoperative ileuas (5[4.6%] vs 11[10.2%]; P = 0.096) in the HS administration patients.Our study demonstrated beneficial postoperative clinical effects of HS intragastric administration in patients who had undergone upper gastrointestinal surgery, such as prompt postoperative gastrointestinal function recovery and reduced overall postoperative complications, which may be attributed to a reduced intestinal edema.

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Section: Introductionmentioning

confidence: 99%

Impact of hypertonic saline on postoperative complications for patients undergoing upper gastrointestinal surgery

et al. 2017

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“…Nutritional status and gastrointestinal immune function of gastric cancer patients tend to worsen postoperatively. Moreover, postoperative weight loss is inevitable, and improving the postoperative condition of these patients has therefore become an important concern in recent years [ 5 – 9 ]. Postoperative weight loss in elderly patients is of particular concern, as it may reduce their quality of life (QOL), increase susceptibility to complications (e.g., postoperative pneumonia and disuse syndrome), extend hospital stay, and decrease the survival rate.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of postoperative elemental diet (Elental®) in elderly patients after gastrectomy

et al. 2016

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BackgroundWe aimed to investigate the efficacy of postoperative early intervention with an elemental diet to reduce weight loss and enhance recovery after gastrectomy. Nutritional status and gastrointestinal immune function tend to worsen, and postoperative weight loss is inevitable in these patients; therefore, improvement in their postoperative condition is important, especially in gastric cancer patients aged ≥80 years.MethodsClinical outcomes and postoperative nutritional status were compared between 21 and 22 consecutive elderly patients aged ≥80 years who underwent distal gastrectomy before and after the introduction of postoperative oral elemental diet (Elental®, 300 kcal/day), respectively, between October 2011 and June 2016.ResultsA significant reduction in postoperative complications was noted in the nutrition support group (N-group) as compared with the control group (C-group). In particular, the prevalence of systemic complications was significantly lower in the N-group (33.3 vs. 4.5 %, p = 0.015), whereas no significant difference was observed in the prevalence of locoregional complications. The percentage of weight loss and reduction in BMI from 1 month to 1 year after surgery was significantly lower in the N-group (p = 0.012 each). The nutrition status (albumin, total protein, hemoglobin, and C-reactive protein levels) at 1 month after surgery showed improvements (p = 0.005, p = 0.048), and hospital stay was decreased in the N-group as compared to the C-group (16.0 vs. 12.5 days, p = 0.041).ConclusionsEarly intervention with an elemental diet after distal gastrectomy is valuable for reducing perioperative weight loss and improving nutritional management and may be associated with enhanced postoperative recovery in elderly patients.

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“…Between January 2015 and February 2017, totally 50 patients at the Department of General Surgery, Chennai Medical College & Hospital who had undergone various abdominal surgeries both emergency. 3 and elective were offered participation, and those who agreed gave informed consent. Out of the 50 cases, 25 were subjected to the study and remaining 25 were the control subjects.…”

Section: Methodsmentioning

confidence: 99%

An Analytical Study on Early Enteral Feeding in Abdominal Surgeries

Hussain¹,

Natraj²,

Rajachidambaram³

2017

jebmh

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BACKGROUND Studies were undertaken to evaluate whether different abdominal surgeries could benefit from early enteral feeding. Early feeding improves the outcomes of patients with trauma and burns, although few studies have examined its use after surgeries. This study compares an early regular diet to conventional postoperative dietary management to determine GI complications after abdominal surgeries. The aim of the study is to analyse and compare early enteral feeding with conventional postoperative dietary management to access complications after abdominal surgeries. MATERIALS AND METHODS Place of study-Department of General Surgery, Chennai Medical College and Research Centre. Period of study-Between January 2015 to February 2017. Totally, 50 patients who had undergone various abdominal surgeries in that 25 cases are subjected to study and remaining 25 were control objects. RESULTS The results of our study the effect of enteral feeding analysed by the main outcome measures like vomiting, wound infection, mortality showed significant betterment to the control group. The length of the hospital stay was relatively less. CONCLUSION This study provides evidence to support the use of enteral feeding in surgical patients and indicate no increased morbidity or mortality. For early enteral nutrition to be effective, it must actually be received and tolerated by the patient.

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Effects of Early Enteral Nutrition on Patients After Emergency Gastrointestinal Surgery

Cited by 37 publications

References 22 publications

Impact of hypertonic saline on postoperative complications for patients undergoing upper gastrointestinal surgery

Impact of hypertonic saline on postoperative complications for patients undergoing upper gastrointestinal surgery

Effectiveness of postoperative elemental diet (Elental®) in elderly patients after gastrectomy

An Analytical Study on Early Enteral Feeding in Abdominal Surgeries

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