Randomized clinical trial of the impact of early enteral feeding on postoperative ileus and recovery

Han-Geurts, Ingrid J M; Hop, Wim C. J.; Kok, Niels F. M.; Lim, Arthur; Brouwer, K. J.; Jeekel, J.

doi:10.1002/bjs.5753

Cited by 170 publications

(124 citation statements)

References 27 publications

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“…Each recommendation was then put to the vote and suggestions, by means of an anonymous questionnaire for collecting information, specially constructed for the elaboration of this Guideline, using the online SurveyMonkey® tool or only postoperatively than only preoperatively 37 . [80][81][82] . The oral route should be the first option for early feedback, even after large procedures 83 .…”

Section: Methodsmentioning

confidence: 99%

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

De-Aguilar-Nascimento

Salomão

Waitzberg

et al. 2017

Rev. Col. Bras. Cir.

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Objective: to present recommendations based on the ACERTO Project (Acceleration of Total Post-Operative Recovery) and supported by evidence related to perioperative nutritional care in General Surgery elective procedures. Methods: review of relevant literature from 2006 to 2016, based on a search conducted in the main databases, with the purpose of answering guiding questions previously formulated by specialists, within each theme of this guideline. We preferably used randomized controlled trials, systematic reviews and meta-analyzes but also selected some cohort studies. We contextualized each recommendation-guiding question to determine the quality of the evidence and the strength of this recommendation (GRADE). This material was sent to authors using an open online questionnaire. After receiving the answers, we formalized the consensus for each recommendation of this guideline. Results: the level of evidence and the degree of recommendation for each item is presented in text form, followed by a summary of the evidence found. Conclusion: this guideline reflects the recommendations of the group of specialists of the Brazilian College of Surgeons, the Brazilian Society of Parenteral and Enteral Nutrition and the ACERTO Project for nutritional interventions in the perioperative period of Elective General Surgery. The prescription of these recommendations can accelerate the postoperative recovery of patients submitted to elective general surgery, with decrease in morbidity, length of stay and rehospitalization, and consequently, of costs.

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Section: Methodsmentioning

confidence: 99%

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

De-Aguilar-Nascimento

Salomão

Waitzberg

et al. 2017

Rev. Col. Bras. Cir.

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“…There is no advantage in keeping patients fasted after elective gastrointestinal resection -early feeding reduces the risk of infection and length of stay and is not associated with an increased risk of anastomotic dehiscence. 53,54 If intravenous fluid therapy is required, excess salt should be avoided, as patients do not have the same ability to excrete sodium and chloride postoperatively. 2 Most patients will be in positive sodium and fluid balance; hence, for patients requiring intravenous fluids, the aim should be to administer low-sodium low-volume fluids to enable patients to return their sodium and fluid balance to zero over the perioperative period.…”

Section: Postoperative Fluid Managementmentioning

confidence: 99%

Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS)

Miller

Roche

Mythen

2014

Can J Anesth/J Can Anesth

230

137

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Optimal perioperative fluid management is an important component of Enhanced Recovery After Surgery (ERAS) pathways. Fluid management within ERAS should be viewed as a continuum through the preoperative, intraoperative, and postoperative phases. Each phase is important for improving patient outcomes, and suboptimal care in one phase can undermine best practice within the rest of the ERAS pathway. The goal of preoperative fluid management is for the patient to arrive in the operating room in a hydrated and euvolemic state. To achieve this, prolonged fasting is not recommended, and routine mechanical bowel preparation should be avoided. Patients should be encouraged to ingest a clear carbohydrate drink two to three hours before surgery. The goals of intraoperative fluid management are to maintain central euvolemia and to avoid excess salt and water. To achieve this, patients undergoing surgery within an enhanced recovery protocol should have an individualized fluid management plan. As part of this plan, excess crystalloid should be avoided in all patients. For low-risk patients undergoing low-risk surgery, a ''zero-balance'' approach might be sufficient. In addition, for most patients undergoing major surgery, individualized goal-directed fluid therapy (GDFT) is recommended. Ultimately, however, the additional benefit of GDFT should be determined based on surgical and patient risk factors. Postoperatively, once fluid intake is established, intravenous fluid administration can be discontinued and restarted only if clinically indicated. In the absence of other concerns, detrimental postoperative fluid overload is not justified and ''permissive oliguria'' could be tolerated.Résumé La gestion périopératoire optimale des liquides est un élément important des programmes de récupération rapide après la chirurgie (RRAC). La gestion des liquides dans le cadre de la RRAC doit être vue comme un continuum au travers des phases pré-, per-et postopératoires. Chaque phase est importante pour améliorer la condition du patient et des soins sous-optimaux au cours d'une de ces phases peuvent miner les meilleures pratiques déployées tout au long de la RRAC. L'objectif de la gestion préopératoire des liquides est de faire en sorte que le patient entre en salle d'opération correctement hydraté et dans un état euvolémique. Pour y parvenir, un jeûne prolongé n'est pas recommandé et le nettoyage mécanique de l'intestin est à éviter. Les patients doivent être encouragés à absorber une boisson claire riche en hydrates de carbone, deux à trois heures avant la chirurgie. Les buts de la gestion peropératoire des liquides sont de maintenir une euvolémie centrale et d'éviter un excès de sel et d'eau. Pour y parvenir, les patients subissant une intervention chirurgicale dans le cadre d'un protocole de récupération rapide devraient avoir un programme personnalisé de gestion des liquides. Dans le cadre de ce plan, l'excès de cristalloïdes doit être évité chez tous les patients. Pour des patients à faible risque subissant une intervention c...

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“…Многочисленные сравнительные клинические исследования раннего эн-терального кормления больных против «послеопера-ционного голодания», а также систематические обзоры и мета анализы полученных данных показали отсутст-вие преимуществ голодания больных после операций на ободочной кишке [16,17]. Раннее восстановление перорального питания снижает риск осложнений, преж-де всего инфекционных, и длительность пребывания в стационаре, а также не связано с повышенным рис-ком несостоятельности анастомозов.…”

Section: Discussionunclassified

Effect of standardized algorithm for perioperative management on the results of right-sided hemicolectomy in elderly patients

Лядов¹,

Кочатков²,

Negardinov³

2016

Onkol. koloproktol.

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Randomized clinical trial of the impact of early enteral feeding on postoperative ileus and recovery

Cited by 170 publications

References 27 publications

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

ACERTO guidelines of perioperative nutritional interventions in elective general surgery

Fluid management and goal-directed therapy as an adjunct to Enhanced Recovery After Surgery (ERAS)

Effect of standardized algorithm for perioperative management on the results of right-sided hemicolectomy in elderly patients

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