The importance of early postoperative enteral feeding

There are still many uncertainties about giving early postoperative enteral nutrition to patients undergoingmajor abdominal surgery. In this article we describe some possible benefits of early feeding through a brief review of the literature and results from a placebo-controlled study of early postoperative enteral feeding in patients undergoing predominantly lower gastrointestinal surgery. This study showed a reduction of postoperative infections. Other studies have not been able to show the same benefit. Possible reasons for these discrepant findings are discussed. In certain situations, early postoperative nutrition may be cost-effective because of fewer re-operations, fewer days in the intensive care unit, and fewer infections. Previously unpublished data suggest that enteral nutrition has an influence upon the postoperative shift of fluid which may be an important mechanism explaining its effects. One of the greatest barriers to the introduction of early postoperative nutrition into a surgical department seems to be the disagreement among surgeons about this procedure and its relevance. Results from a Danish department show that it is possible to administer about 90% of the required daily energy intake during the first 2 postoperative days after acute and elective abdominal surgery through the use of a nasoduodenal tube.