A comparative study between early enteral feeding (within 24 hours) versus conventional enteral feeding after enteric anastomosis

Chatterjee, Souvik; Bala, Sujoy Kumar; Chakraborty, Partha Pratim; Dey, Rajesh; Sinha, S.; Ray, Ramdip; Rahed, Abdur

doi:10.3329/bjms.v11i4.12597

Cited by 12 publications

(4 citation statements)

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“…These RCTs described their early nutrition intervention as “water” (Wang et al, 2013 ), “5% glucose” (Cao, 2009 ; Li et al, 2006 ), “clear liquid” (Reissman et al, 1995 ; Pragatheeswarane et al, 2014 ), “allowed to drink” (Feo et al, 2004 ), “oral liquids” (Chatterjee et al, 2012 ), an “oral liquid diet” (da Fonseca et al, 2011 ), a “fluid diet” (Dag et al, 2011 ), “fluids” (El et al, 2009 ), a “liquid diet” (Hartsell et al, 1997 ), a “semi-fluid diet” (Lee et al, 2011 ), or “filtrate liquids” (Nematihonar et al, 2018 ).…”

Section: Resultsmentioning

confidence: 99%

Early oral protein-containing diets following elective lower gastrointestinal tract surgery in adults: a meta-analysis of randomized clinical trials

Heighes

Simpson

et al. 2021

Perioper Med

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Background Although current guidelines make consensus recommendations for the early resumption of oral intake after surgery, a recent comprehensive meta-analysis failed to identify any patient-centered benefits. We hypothesized this finding was attributable to pooling studies providing effective protein-containing diets with ineffective non-protein liquid diets. Therefore, the aim of this paper was to investigate the safety and efficacy of early oral protein-containing diets versus later (traditional) feeding after elective lower gastrointestinal tract surgery in adults. Methods PubMed, Embase, and the China National Knowledge Infrastructure databases were searched from inception until 1 August 2019. Reference lists of retrieved studies were hand searched to identify randomized clinical trials reporting mortality. No language restrictions were applied. Study selection, risk of bias appraisal and data abstraction were undertaken independently by two authors. Disagreements were settled by obtaining an opinion of a third author. Majority decisions prevailed. After assessment of underlying assumptions, a fixed-effects method was used for analysis. The primary outcome was mortality. Secondary outcomes included surgical site infections, postoperative nausea and vomiting, serious postoperative complications and other key measures of safety and efficacy. Results Eight randomized clinical trials recruiting 657 patients were included. Compared with later (traditional) feeding, commencing an early oral protein-containing diet resulted in a statistically significant reduction in mortality (odds ratio [OR] 0.31, P = 0.02, I2 = 0%). An early oral protein-containing diet also significantly reduced surgical site infections (OR 0.39, P = 0.002, I2 = 32%), postoperative nausea and vomiting (OR 0.62, P = 0.04, I2 = 37%), serious postoperative complications (OR 0.60, P = 0.01, I2 = 25%), and significantly improved other major outcomes. No harms attributable to an early oral protein-containing diet were identified. Conclusions The results of this systematic review can be used to upgrade current guideline statements to a grade A recommendation supporting an oral protein-containing diet commenced before the end of postoperative day 1 after elective lower gastrointestinal surgery in adults.

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Section: Resultsmentioning

confidence: 99%

Early oral protein-containing diets following elective lower gastrointestinal tract surgery in adults: a meta-analysis of randomized clinical trials

Heighes

Simpson

et al. 2021

Perioper Med

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“…A sample size of 50 patients (25 for EOF and TOF each) was determined using the formula for comparing two means: n = (Z α + Z β ) 2 × (σ 1 2 + σ 2 2 ) / (µ 1 - µ 2 ) 2 . The calculation took into account a 95% confidence interval (CI), a power of 80%, and the mean values of 2.65 ± 0.917 and 3.4 ± 0.867 days for the resumption of oral feeding following gastrointestinal surgery in EOF and TOF, respectively [ 15 ]. A total of 50 adult patients who met the criteria for gastrointestinal surgery were chosen to participate in the trial.…”

Section: Methodsmentioning

confidence: 99%

The Outcome of Early Oral Feeding Following Elective Gastrointestinal Surgery

Mahmud,

Hasan,

Hakim

et al. 2024

Cureus

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Background Early oral feeding (EOF) after gastrointestinal (GI) surgery is an optimistic way to speed up recovery and shorten hospital stays, but its full effects remain unexplored. Aim This study aims to evaluate the outcomes of EOF in patients having elective gastrointestinal surgery. Methods This open-level, prospective randomized controlled trial was conducted in the Department of Surgery at Sir Salimullah Medical College Mitford Hospital, Dhaka, from March 2022 to February 2023. A total of 50 patients were enrolled and divided into two groups: early oral feeding (EOF) and traditional postoperative oral feeding (TOF), both before and after 48 hours of surgery, using a systematic random sampling technique. Informed written consent was taken from the patients. The patients were monitored on days 1, 3, 5, 7, 14, and 28 following surgeries. Postoperative complications, the duration for nasogastric tube (NGT) removal (days), the early recovery of bowel motility, and the length of the hospital stay (days) were noted. Results In this study, both EOF and TOF groups were found indifferent in terms of age distribution, gender ratio, or body mass index (BMI). However, significant differences emerged in postoperative outcomes. The TOF group experienced a significantly longer duration for nasogastric tube (NGT) removal and the initiation of oral feeding compared to the EOF group (P-value < 0.001). Complication rates, including nausea, vomiting, ileus, anastomotic leakage, wound infection, and pneumonia, did not exhibit statistically significant differences between the groups (P-value > 0.05). Moreover, the EOF group demonstrated an early recovery of bowel motility after surgery and shorter hospital stays compared to the TOF group (P-value < 0.05). Conclusion Starting oral feeding earlier does not increase complications. However, it does speed up recovery and shorten hospital stays.

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“…Our study and all other similar studies had a male participant's preponderance in each groups and the differences was statistically insignificant. 11,12 Type of surgery…”

Section: Sex Distributionmentioning

confidence: 99%

Early enteral feeding in patients with gastrointestinal surgery time to send the patient home early

2022

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Background: There has been a trend among surgeons to delay enteral feeding following gastrointestinal surgery so that complications like anastomotic site leak and infection can be prevented and also to give time for operated site to heal. Newer studies suggest that early enteral feeding is useful in comparison to conventional method of feeding i.e. waiting for bowel function to return. This study was undertaken to evaluate the safety and tolerability of early enteral feeding after gastrointestinal surgeries in terms of postoperative complications and length of hospitalization.Methods: This study was prospective observational study with retrospective controls done over a period of 18 months at a tertiary care center in India. 35 patients were included in each group (case versus control). Early enteral feeding was defined as commencement of oral feed within 48 hours of surgery. The data was analyzed using statistical package of social science (SPSS Version 20; Chicago Inc., USA).Results: Both groups were found to be well matched in terms of age and sex distribution. The mean hospital stay for patients given early enteral feeding was significantly lower as compared to controls (10.26±3.09 versus 13.4±2.186). They had a complication rate of 11.4 % as compared to late enteral feeding group (25.7%).Conclusions: Early enteral feeding has been found beneficial in most of the studies worldwide. Hence, it is time to open our minds and embrace it to improve surgical outcome in gastrointestinal surgery practice.

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A comparative study between early enteral feeding (within 24 hours) versus conventional enteral feeding after enteric anastomosis

Cited by 12 publications

References 0 publications

Early oral protein-containing diets following elective lower gastrointestinal tract surgery in adults: a meta-analysis of randomized clinical trials

Early oral protein-containing diets following elective lower gastrointestinal tract surgery in adults: a meta-analysis of randomized clinical trials

The Outcome of Early Oral Feeding Following Elective Gastrointestinal Surgery

Early enteral feeding in patients with gastrointestinal surgery time to send the patient home early

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