Suehiro Taketoshi, Matsumata Takashi, Shikada Yasunori, Sugimachi Keizo
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Hepatogastroenterology. 2004 Nov-Dec;51(60):1852-5.
BACKGROUND/AIMS: To evaluate the safety and efficacy of early oral feeding in patients undergoing gastrectomy.
One hundred patients undergoing gastrectomy were studied. Patients in the early oral feeding group (Early group) began a liquid diet within 48 hours after operation and patients within the Traditional group received nothing by mouth until the resolution of the ileus. All of the patients were monitored for vomiting, abdominal distention, length of ileus, tolerance of regular diet, duration of intravenous fluid administration, length of hospitalization, and complications.
The time to flatus was 55.5+/-12.5 hours and 78.0+/-22.2 hours in the Early and Traditional group, respectively (p<0.05). And fasting period was 2.14+/-1.08 days and 5.93+/-2.35 days in the Early and Traditional group, respectively (p<0.05). In addition, duration of intravenous fluid administration was shorter in the patients in the Early group compared with Traditional group (5.7+/-1.7 days vs. 9.2+/-3.9 days, p<0.05). As a result, length of postoperative hospitalization in the patients in the Early group was significantly shorter than those in the Traditional group (16.2+/-5.3 days vs. 23.4+/-9.8 days, p<0.05). The incidence of complications including nausea, vomiting, anastomotic leak and wound infection occurred equally in both groups.
Early oral feeding after gastrectomy is safe, with no evidence of increased morbidity, and early postoperative oral feeding is also highly effective in reducing hospital stay.
背景/目的:评估胃癌切除术患者早期经口进食的安全性和有效性。
对100例行胃癌切除术的患者进行研究。早期经口进食组(早期组)患者在术后48小时内开始流食,传统组患者在肠梗阻解除前禁食。所有患者均监测呕吐、腹胀、肠梗阻持续时间、正常饮食耐受性、静脉输液时间、住院时间及并发症情况。
早期组和传统组的排气时间分别为55.5±12.5小时和78.0±22.2小时(p<0.05)。早期组和传统组的禁食期分别为2.14±1.08天和5.93±2.35天(p<0.05)。此外,早期组患者的静脉输液时间比传统组短(5.7±1.7天 vs. 9.2±3.9天,p<0.05)。结果,早期组患者的术后住院时间明显短于传统组(16.2±5.3天 vs. 23.4±9.8天,p<0.05)。两组恶心、呕吐、吻合口漏及伤口感染等并发症的发生率相同。
胃癌切除术后早期经口进食是安全的,没有发病率增加的证据,且术后早期经口进食在缩短住院时间方面也非常有效。