Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications

Herbert, Georgia; Perry, Rachel; Andersen, Henning; Atkinson, Charlotte; Penfold, Chris; Lewis, Stephen J.; Ness, Andy R; Thomas, Steven J.

doi:10.1002/14651858.cd004080.pub4

Cited by 74 publications

(86 citation statements)

References 134 publications

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“…Early oral nutrition is advocated by ERAS programs in postsurgical recovery, with some studies supporting an early oral diet to safe, feasible, and shorter hospital stays than noninterventional groups. However, whether oral nutrition can reduce postoperative complications requires further investigation [ 63 , 64 , 65 ]. Cluster 4 correlates to perioperative pain management.…”

Section: Discussionmentioning

confidence: 99%

The Pertinent Literature of Enhanced Recovery after Surgery Programs: A Bibliometric Approach

Cheng

Zhao

et al. 2021

Medicina

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Background and Objectives: The programs of enhanced recovery after surgery are the new revolution in surgical departments; however, features of this concept have not been systematically explored. Therefore, the purpose of this study was to explore Enhanced recovery after surgery (ERAS)-related research using bibliometric analysis. Materials and Methods: The search strategy of ERAS programs was conducted in the Web of Science database. Bibliometric analysis was further performed by Excel and Bibliometrix software. The relationship between citation counts and Mendeley readers was assessed by linear regression analysis. Results: 8539 studies from 1994–2019 were included in the present research, with reporting studies originating from 91 countries using 18 languages. The United States (US) published the greatest number of articles. International cooperation was discovered in 82 countries, with the most cooperative country being the United Kingdom. Henrik Kehlet was found to have published the highest number of studies. The journal Anesthesia and Analgesia had the largest number of articles. Linear regression analysis presented a strong positive correlation between citations and Mendeley readers. Most research was related to gastrointestinal surgery in this field. Conclusion: This bibliometric analysis shows the current status of ERAS programs from multiple perspectives, and it provides reference and guidance to scholars for further research.

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Section: Discussionmentioning

confidence: 99%

The Pertinent Literature of Enhanced Recovery after Surgery Programs: A Bibliometric Approach

Cheng

Zhao

et al. 2021

Medicina

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“…Post‐surgical complications were reduced when enteral nutrition was introduced early. Mortality was reduced in the early enteral feeding groups . The introduction of early nutrition does not increase morbidity or mortality as compared to total parental nutrition.…”

Section: Discussionmentioning

confidence: 81%

“…Andersen et al . published a Cochrane systematic review of 13 randomized controlled trials with a total of 1173 patients . Post‐surgical complications were reduced when enteral nutrition was introduced early.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Foley catheter insertion into defunctioning ileostomy to reduce obstruction after colorectal surgery: pilot randomized controlled trial*

Kulasegaran

Nisbet

et al. 2020

ANZ Journal of Surgery

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Background Defunctioning ileostomies provide faecal diversion in major colorectal surgery. This reduces the consequences of an anastomotic leak. However, the formation of an ileostomy carries risks including obstruction at the level of the fascia. Post‐operative oedema at the level of the fascia may contribute to obstruction. We hypothesize that the prophylactic insertion of a Foley catheter into the afferent limb of a defunctioning loop ileostomy may help decompress and improve time to low‐residue diet (LRD). The objective of the study was to assess the feasibility of a Foley catheter, prophylactically inserted into the afferent limb of a defunctioning loop ileostomy, after major colorectal surgery. Methods The study was a prospective pilot‐randomized controlled trial. Ethical approval was obtained from Northern B Health and Disability Ethics Committee 15/NTB/91 ANZCTR Trial ID: ACTRN12615000691549. Results Forty‐nine patients undergoing major elective colorectal surgery with a defunctioning ileostomy, between the years of 2015 and 2018 at North Shore Hospital, Auckland, New Zealand were included in this study. Patients were randomly allocated to either the Foley catheter (n = 26) or non‐Foley catheter (n = 23) group. The median time taken to tolerate LRD the primary outcome, was 2 days in the Foley group versus 2 days in the non‐Foley group (P = 0.05). There were no differences in the secondary outcome measures such as time to stoma output, length of stay or complications. Conclusion This trial failed to show a statistical difference in time taken to tolerate a LRD residue in the Foley catheter group. There was no difference in length of stay, time to flatus or stoma output.

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“…One trial reported differences in median hospital stay (Beier-Holgersen & Boesby, 1996), with the remaining seven reporting mean (SD). Mean (SD) hospital stay data for the trials by Minig et al, Mulrooney et al, and Stewart et al was abstracted from the systematic review by Herbert et al (Herbert et al, 2019) Herbert et al reported corresponding with these authors to obtain this additional mean (SD) information regarding hospital stay. Using a non-parametric test, the individual RCT conducted by Beier-Holgersen et al reported a trend towards a reduction in median hospital stay for patients who received an early diet containing protein: median 8 vs. 11.5 days (P = 0.08) (Beier-Holgersen & Boesby, 1996).…”

Section: Duration Of Hospital Staymentioning

confidence: 99%

“…Meta-analyses have shown that, compared to later (traditional) feeding, early oral intake after elective colorectal surgery may significantly reduce postoperative infections (Lewis et al, 2001 ), serious postoperative complications (Osland et al, 2011 ), anastomotic leaks (Smeets et al, 2018 ), and mortality (Lewis et al, 2009 ). However, the most comprehensive systematic review and meta-analysis conducted by leading experts on the topic, updated in 2019, did attribute a significant reduction in hospital stay to early oral intake but it failed to confirm any of these previously reported important patient-centered clinical benefits (Herbert et al, 2019 ). All of these previous meta-analyses based their conclusions on a pooled assessment of protein - containing diets with non - protein liquid diets.…”

Section: Introductionmentioning

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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Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications

Cited by 74 publications

References 134 publications

The Pertinent Literature of Enhanced Recovery after Surgery Programs: A Bibliometric Approach

The Pertinent Literature of Enhanced Recovery after Surgery Programs: A Bibliometric Approach

Prophylactic Foley catheter insertion into defunctioning ileostomy to reduce obstruction after colorectal surgery: pilot randomized controlled trial*

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

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