Frizon Eliani, Aguilar-Nascimento José Eduardo de, Zanini Júlio Cesar, Roux Mariah Steinbach, Schemberg Bruna Caroline de Lima, Tonello Pamela Luiza, Dock-Nascimento Diana Borges
Universidade Federal da Fronteira Sul, Nutrition Course - Realeza (PR), Brazil.
Universidade Federal do Mato Grosso, Faculty of Medicine, Postgraduate in Health Sciences - Cuiabá (MT), Brazil.
Arq Bras Cir Dig. 2025 Jan 20;37:e1854. doi: 10.1590/0102-6720202400060e1854. eCollection 2025.
Multimodal protocols such as Acceleration of Total Postoperative Recovery and Enhanced Recovery After Surgery propose a set of pre- and post-operative care to accelerate the recovery of surgical patients. However, in clinical practice, simple care such as early refeeding and use of drains are often neglected by multidisciplinary teams.
Investigate whether early postoperative refeeding determines benefits in colorectal oncological surgery; whether the patients' clinical conditions preoperatively and the use of a nasogastric tube and abdominal drain delay their recovery.
Retrospective cohort carried out at the Cascavel Uopeccan Cancer Hospital, including adult cancer patients (age ≥18 years), from the Unified Health System (SUS), who underwent colorectal surgeries from January 2018 to December 2021.
275 patients were evaluated. Of these, 199 (75.4%) were refed early. Late refeeding (odds ratio - OR=2.1; p=0.024), the use of nasogastric tube (OR=2.72; p=0.038) and intra-abdominal drain (OR=1.95; p=0.054) increased the chance of infectious complication. Multivariate analysis showed that receiving a late postoperative diet is an independent risk factor for infectious complications. Late refeeding (p=0.006) after the operation and the placement of an intra-abdominal drain (p=0.007) are independent risk factors for remaining hospitalized for more than five days postoperatively.
Refeeding early in the postoperative period reduces the risk of infectious complications. Using abdominal drains and refeeding late (>48h) for cancer patients undergoing colorectal surgery are risk factors for hospital stays longer than five days.
多模式方案，如“加速术后全面康复”和“术后强化康复”，提出了一套术前和术后护理措施，以加速手术患者的康复。然而，在临床实践中，多学科团队往往忽视了早期重新进食和使用引流管等简单护理措施。
研究术后早期重新进食是否对结直肠肿瘤手术有益；患者术前的临床状况以及使用鼻胃管和腹腔引流管是否会延迟其康复。
在卡斯卡韦尔乌奥佩坎癌症医院进行回顾性队列研究，纳入2018年1月至2021年12月期间来自统一卫生系统（SUS）、接受结直肠手术的成年癌症患者（年龄≥18岁）。
共评估了275例患者。其中，199例（75.4%）早期重新进食。延迟重新进食（优势比-OR=2.1；p=0.024）、使用鼻胃管（OR=2.72；p=0.038）和腹腔引流管（OR=1.95；p=0.054）增加了感染并发症的发生几率。多因素分析显示，术后接受延迟饮食是感染并发症的独立危险因素。术后延迟重新进食（p=0.006）和放置腹腔引流管（p=0.007）是术后住院超过五天的独立危险因素。
术后早期重新进食可降低感染并发症的风险。对于接受结直肠手术的癌症患者，使用腹腔引流管和延迟重新进食（>48小时）是住院时间超过五天的危险因素。
