Early enteral nutrition after surgical treatment of gut perforations: A prospective randomised study
BACKGROUND: Withholding enteral feeds after an elective gastrointestinal surgery is based on the hypothesis that this period of "nil by mouth" provides rest to the gut and promotes healing. AIMS: To assess whether early postoperative naso-gastric tube feeding in the form of a balanced diet...
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Published in | Journal of postgraduate medicine (Bombay) Vol. 50; no. 2; pp. 102 - 106 |
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Main Author | |
Format | Journal Article |
Language | English |
Published |
India
Medknow Publications and Staff Society of Seth GS Medical College and KEM Hospital, Mumbai, India
01.04.2004
Medknow Publications & Media Pvt. Ltd |
Subjects | |
Online Access | Get full text |
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Summary: | BACKGROUND: Withholding enteral feeds after an elective
gastrointestinal surgery is based on the hypothesis that this period of
"nil by mouth" provides rest to the gut and promotes healing. AIMS:
To assess whether early postoperative naso-gastric tube feeding in the
form of a balanced diet formula is safe in and beneficial to patients
who have undergone surgical intervention for perforation of the gut.
SETTING: A surgical unit of a Medical College Hospital. DESIGN AND
SUBJECTS: Prospective randomised open control study. METHODS AND
MATERIAL: Patients undergoing surgical intervention for peritonitis
following perforation of the gut were randomised to the study group
receiving feedings of a balanced diet formula through a naso-gastric
tube from the second postoperative day, or the control group in which
patients were managed with the conventional regimen of intravenous
fluid administration. The groups were compared for incidence and
duration of complications, biochemical measurements and other
characteristics like weight loss/gain. STATISTICAL ANALYSIS: Chi
square test and 'T' test. RESULTS: One hundred patients were enrolled
in each group. 88% subjects in the study group achieved positive
nitrogen balance on the eighth postoperative day as compared to none in
the conventionally managed group. The relative risks (95% confidence
interval) of morbidity from wound infection, wound dehiscence,
pneumonia, leakage of anastomoses and septicaemia were 0.66
(0.407-1.091), 0.44 (0.141-1.396), 0.70 (0.431-1.135), 0.54
(0.224-1.293) and 0.66 (0.374-1.503) respectively. Average loss of
weight between the first and tenth day was 3.10 kg in the study group
as compared to 5.10 kg in the conventionally managed group ('P' value
< 0.001, 95% Confidence Interval - 2.46 - 1.54). CONCLUSION: Early
enteral nutrition is safe and is associated with beneficial effects
such as lower weight loss, early achievement of positive nitrogen
balance as compared to the conventional regimen of feeding in operated
cases of gut perforation. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 ObjectType-News-3 content type line 23 |
ISSN: | 0022-3859 0972-2823 |