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肿瘤学中上消化道切除及一期吻合术后的早期经口进食

EARLY ORAL FEEDING POST-UPPER GASTROINTESTINAL TRACT RESECTION AND PRIMARY ANASTOMOSIS IN ONCOLOGY.

作者信息

Lopes Lilian Pinheiro, Menezes Taysa Machado, Toledo Diogo Oliveira, DE-Oliveira Antônio Talvane Torres, Longatto-Filho Adhemar, Nascimento José Eduardo de Aguilar

机构信息

Nutrition Department.

Intensive Care Department at Albert Einstein Israelite Hospital, São Paulo, SP.

出版信息

Arq Bras Cir Dig. 2018 Jun 21;31(1):e1359. doi: 10.1590/0102-672020180001e1359.

Abstract

BACKGROUND

The practice of starving patients in the immediate period after upper gastrointestinal surgery is widespread. Early oral intake has been shown to be feasible and may result in faster recovery and decrease length of hospital.

AIM

To evaluate the feasibility and safety of oral nutrition on postoperative early feeding after upper gastrointestinal surgeries.

METHODS

Observational cohort design study with convenience retrospective data in both genders, over 18 years, undergoing to total gastrectomy and/or elective esophagectomy. They have received oral or enteral nutrition in less than 48 h after surgery, and among those who started with enteral nutrition, the oral feeding up to seven days.

RESULTS

The study was performed in 161 patients, 24 (14.9%) submitted to esophagectomy, 132 (82%) to total gastrectomy and five (3.1%) to esophagogastrectomy. Was observed good dietary acceptance and low percentage (29%) of gastrointestinal intolerances, more pronounced among those with enteral diet. Most of the patients did not present postoperative complications, 11 (6.8%) were reopened, five (3.1%) had fistulas, three (1.9%) wound dehiscence, three (1.9%) fistula more wound dehiscence and six (3.7%) other non-infectious complications.

CONCLUSION

Early oral diet is safe and viable for patients undergoing upper gastrointestinal surgery.

摘要

背景

上消化道手术后立即让患者禁食的做法很普遍。早期经口进食已被证明是可行的,可能会加快康复速度并缩短住院时间。

目的

评估上消化道手术后早期经口营养支持的可行性和安全性。

方法

采用观察性队列设计研究,对18岁以上接受全胃切除术和/或择期食管切除术的男女患者进行便利抽样回顾性数据收集。他们在术后48小时内接受了经口或肠内营养,在开始肠内营养的患者中,经口喂养持续7天。

结果

该研究共纳入161例患者,其中24例(14.9%)接受了食管切除术,132例(82%)接受了全胃切除术,5例(3.1%)接受了食管胃切除术。观察到患者对饮食的接受度良好,胃肠道不耐受的比例较低(29%),在接受肠内营养的患者中更为明显。大多数患者没有出现术后并发症,11例(6.8%)再次手术,5例(3.1%)发生瘘管,3例(1.9%)伤口裂开,3例(1.9%)瘘管合并伤口裂开,6例(3.7%)出现其他非感染性并发症。

结论

早期经口饮食对上消化道手术患者是安全可行的。

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