Surgery Department, Ladoke Akintola University of Technology, Ogbomoso, Oyo State Email:
Surgery Department, Ekiti State University, Ado-Ekiti, Ekiti State.
West Afr J Med. 2024 Jun 28;41(6):625-629.
Early postoperative oral feeding has been documented to improve outcomes in patients who have undergone open or laparoscopic elective bowel surgeries. Available data on the safety and outcomes of early postoperative oral feeding in patients who underwent emergency gastrointestinal surgeries are inconclusive.
This study was conducted to compare and determine the safety, benefits and outcomes of early postoperative oral feeding and delayed oral feeding after emergency gastrointestinal surgeries.
Sixty patients who underwent emergency gastrointestinal surgeries were randomized either into the early feeding group (EFG) or the delayed feeding group (DFG). The patients in EFG commenced a graded oral liquid diet on postoperative day 1 (POD 1) while patients in DFG were commenced on a graded oral diet after the return of bowel function. The main endpoints were the need to re-insert the nasogastric tube and the overall length of hospital stay.
The mean age of patients in the EFG and DFG were similar ((33.2±8.94 versus 33.9±8.91; p= 0.7407). Seventeen (56.7%) patients in EFG failed to tolerate early oral feeding compared to 8 (26.7%) patients in DFG who failed to tolerate feeding following the commencement of oral feeding (p= 0.036). Of the patients that were unable to tolerate oral feeding; thirteen (76.5%) of the 17 patients in EFG required re-insertion of NG tube for stomach decompression as compared to two (25%) of the 8 patients in DFG (p=0.0441). The mean length of hospital stay was longer in EFG (9±2.34 vs 6.5±1.04; p<0.001).
Early postoperative oral feeding in patients who underwent emergency gastrointestinal surgeries was associated with a high failure rate and increased risk of postoperative complications with a prolonged length of hospital stay.
已证实，对于接受开腹或腹腔镜择期肠手术的患者，早期术后口服喂养可改善预后。关于接受紧急胃肠手术的患者早期术后口服喂养的安全性和结果的可用数据尚无定论。
本研究旨在比较和确定紧急胃肠手术后早期和延迟口服喂养的安全性、益处和结果。
将 60 例接受紧急胃肠手术的患者随机分为早期喂养组（EFG）或延迟喂养组（DFG）。EFG 组患者在术后第 1 天（POD1）开始进行分级口服液体饮食，而 DFG 组患者在恢复肠道功能后开始进行分级口服饮食。主要终点是需要重新插入鼻胃管和总住院时间。
EFG 和 DFG 组患者的平均年龄相似（（33.2±8.94 与 33.9±8.91；p=0.7407）。EFG 中有 17 例（56.7%）患者无法耐受早期口服喂养，而 DFG 中有 8 例（26.7%）患者在开始口服喂养后无法耐受喂养（p=0.036）。在无法耐受口服喂养的患者中，EFG 组中有 13 例（76.5%）需要重新插入 NG 管进行胃减压，而 DFG 组中有 2 例（25%）（p=0.0441）。EFG 的平均住院时间更长（9±2.34 与 6.5±1.04；p<0.001）。
对于接受紧急胃肠手术的患者，早期术后口服喂养与高失败率以及术后并发症风险增加和住院时间延长相关。
