National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol, UK; Bristol Dental School, University of Bristol, Bristol, UK.
Department of Paediatrics, University of Oxford, John Radcliffe Hospital, Oxford, UK.
Clin Nutr ESPEN. 2020 Apr;36:99-105. doi: 10.1016/j.clnesp.2020.01.009. Epub 2020 Feb 8.
Early post-operative feeding is recommended within enhanced recovery after surgery programmes. This study aimed to describe post-operative feeding patterns and associated factors among patients following colorectal surgery, using a post-hoc analysis of observational data from a previous RCT on chewing gum after surgery.
Data from 301 participants (59% male, median age 67 years) were included. Amounts of meals consumed on post-operative days (POD) 1-5 were recorded as: none, a quarter, half, three-quarters, all. 'Early' consumers were those who ate ≥a quarter of a meal on POD1. 'Early' tolerance was the consumption of at least half of three meals on POD1 or 2 without vomiting. Exploration of selected peri-operative factors with early feeding and tolerance were assessed using logistic regression.
222 people (73.8%) consumed solid food early, and 109 people (36.2%) tolerated solid food early. Several factors were associated with postoperative feeding: provision of pre-operative bowel preparation was associated with delayed consumption [odds ratio (OR) 0.34, 95% confidence interval (CI) 0.14-0.83] and tolerance (OR 0.35, 95% CI 0.16-0.81) of food; and laparoscopic/laparoscopic assisted (vs. open/converted to open surgery) was associated with early tolerance of food (OR 1.99, 95% CI 1.17-3.39).
While three-quarters of the study population ate solid food early, only one-third tolerated solid food early. Findings suggest that bowel preparation and surgery type are factors warranting further investigation in future studies to improve uptake of early post-operative feeding.
加速康复外科方案建议术后早期进食。本研究旨在描述结直肠手术后患者的术后喂养模式及相关因素，方法：该研究对一项关于术后咀嚼口香糖的 RCT 的观察性数据进行了事后分析，共纳入 301 名参与者（59%为男性，中位年龄 67 岁）。记录术后第 1-5 天的进食量：无、1/4、1/2、3/4、全部。“早期”进食者为术后第 1 天进食≥1/4 餐者。“早期”耐受是指术后第 1 天或第 2 天至少进食三餐的一半而无呕吐。使用逻辑回归分析评估与早期喂养和耐受相关的选定围手术期因素。结果：222 人（73.8%）早期进食固体食物，109 人（36.2%）早期耐受固体食物。多项因素与术后喂养相关：术前肠道准备与食物摄入延迟[比值比（OR）0.34，95%置信区间（CI）0.14-0.83]和耐受（OR 0.35，95%CI 0.16-0.81）相关；腹腔镜/腹腔镜辅助手术（与开放/中转开放手术相比）与早期耐受食物相关（OR 1.99，95%CI 1.17-3.39）。结论：尽管 75%的研究人群早期进食固体食物，但只有 1/3 的人早期耐受固体食物。这些发现表明，肠道准备和手术类型是值得在未来研究中进一步探讨的因素，以提高术后早期喂养的接受度。
