Early Enteral Nutrition Could Reduce Risk of Recurrent Leakage After Definitive Resection of Anastomotic Leakage After Colorectal Cancer Surgery

Abstract

Background The present study aimed to evaluate the effect of early enteral nutrition (EEN) after definitive resection of anastomotic leakage (DRAL) resulting from a sigmoid colon or rectal cancer radical resection. Methods This was a prospective cohort study performed at our center. From January 2014 to May 2016, every patient received a standard postoperative nutritional protocol (SPNP) after DRAL and was included into SPNP group. From June 2016 to December 2018, all patients received an EEN after DRAL and were included into EEN group. The effect of postoperative EEN was evaluated. Results There were a final total of 133 patients enrolled in our study. There were 70 patients in the SPNP group, and 63 patients in the EEN group. There were 12 cases (19.05%) with a recurrent leakage in the EEN group, and 28 cases (40%) in the SPNP group. The recurrent rate was associated with EEN (HR = 0.417, 95% CI 0.196–0.890, p = 0.024). The median defecation time in the EEN group was 5(4–7) days, while in the SPNP group was 7(6–8.25) days. The defecation was associated with EEN (HR = 1.588, 95% CI 1.080–2.336, p = 0.019), as well. Conclusion EEN could reduce the recurrent leakage rate and defecation time after definitive resection of anastomotic leakage resulting from sigmoid colon or rectal cancer radical resection.

Duration of Postoperative Hyperlactatemia Has Predictive Value in Recurrent Fistula After Major Definitive Surgery for Intestinal Fistula

“…The process of complicated de nitive surgery for intestinal stula seems to be an abdominal surgeon's nightmare. During the process, the anatomical structure is disordered, the adhesion is severe, and there is a large amount of extensive bleeding in the operation eld 7,8 . The above factors cause severe postoperative stress in the patients; thus, leading to release of cytokines and in ammatory mediators (including tumor necrosis factor alpha (TNF-α), and several interleukins (IL-1, IL-6, and IL-8)) 17 .…”

“…Intestinal stula is a potentially life-threatening pathological condition 1 , which results from in ammatory bowel disease (IBD) 2 , malignant tumor 3 , intestinal radiation injury 4 , and iatrogenic causes 5 . With good infection control and nutritional support, spontaneous closure might occur in a considerable number of patients 5,6 ; however, de nitive surgical treatment is the main treatment method 7 . In patients who undergo a complicated surgical process, the process can be quite di cult and bumpy 7 , and there could be a very high incidence of complications 7,8 .…”

“…With good infection control and nutritional support, spontaneous closure might occur in a considerable number of patients 5,6 ; however, de nitive surgical treatment is the main treatment method 7 . In patients who undergo a complicated surgical process, the process can be quite di cult and bumpy 7 , and there could be a very high incidence of complications 7,8 . In our previous study, the rate of recurrent stula (RF) was as high as 30% after complicated de nitive surgery 7 .…”

“…In patients who undergo a complicated surgical process, the process can be quite di cult and bumpy 7 , and there could be a very high incidence of complications 7,8 . In our previous study, the rate of recurrent stula (RF) was as high as 30% after complicated de nitive surgery 7 . As a result, exploration of the possible factors of RF is an important topic of surgical treatment.…”

Current Insights: The Impact of Gut Microbiota on Postoperative Complications in Visceral Surgery—A Narrative Review

“…Factors contributing to or increasing the risk of postoperative anastomotic leakage, adapted from McDermott et al and other recent research results[26,29,35,[61][62][63][64][65][66][67][68].…”