Is early feeding after major gastrointestinal surgery a fashion or an advance? Evidence-based review of literature
Autor: | Guruprasad S. Shetty, Kailash K Singh, Shailesh V. Shrikhande, Sachin Ingle |
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Rok vydání: | 2010 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Enteral administration law.invention Enteral Nutrition Randomized controlled trial law medicine Humans Radiology Nuclear Medicine and imaging Adverse effect Intensive care medicine Digestive System Surgical Procedures Randomized Controlled Trials as Topic Evidence-Based Medicine business.industry General surgery General Medicine Perioperative Surgery Parenteral nutrition Oncology Esophagectomy Pancreatectomy Complication business |
Zdroj: | Journal of cancer research and therapeutics. 5(4) |
ISSN: | 1998-4138 |
Popis: | Early enteral nutrition (EN) after major digestive surgery has been receiving increasing attention. Supporting evidence has not been clear. This evidence-based review traces the development of early EN and analyses whether it is indeed an advance. We performed a PubMed search in October 2009 with the key words enteral nutrition, early feeding, and gastrointestinal surgery. Our emphasis was on earliest studies documenting the benefits or adverse effects of EN, comparative studies, documenting the benefits or adverse effects of EN, comparative studies, and randomized controlled trials. Thirty-one results were returned from which 17 were included for evaluation (1979-2009). Fifteen papers concluded that early EN was beneficial. In general, patients put on early EN and immunonutrition postoperatively seemed to have decreased hospital stay, decreased complication rates, decreased treatment and hospital costs, and even decreased morbidity and mortality; however, judicious use has been suggested. One study did not recommend early enteral feeding in well-nourished patients at low risk of nutrition-related complications and another suggested that immunonutrition is not beneficial and should not be used routinely. Early EN has been safely given after major digestive surgery since 1979. It benefits patients undergoing major gastrointestinal (GI) surgeries, with reduction in perioperative infection, better maintainance of nitrogen balance, and shorter hospital stay. Early EN may be superior to total parenteral nutrition (TPN). However, TPN is perhaps better tolerated in the immediate postoperative period. Early enteral immunonutrition should be used only in malnourished and in transfused patients. Early EN after major digestive surgery is an old advance that is now in fashion. |
Databáze: | OpenAIRE |
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