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Early Feeding Is Feasible after Emergency Gastrointestinal Surgery
Authors:Hyung Soon Lee  Hongjin Shim  Ji Young Jang  Hosun Lee  Jae Gil Lee
Institution:1.Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.;2.Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.;3.Severance Hospital Nutrition Support Team, Seoul, Korea.
Abstract:

Purpose

This study was undertaken to assess the feasibility of early feeding in patients that have undergone emergency gastrointestinal (GI) surgery.

Materials and Methods

The authors retrospectively reviewed 84 patients that underwent emergency bowel resection and/or anastomosis from March 2008 to December 2011. Patients with severe shock, intestinal ischemia, sustained bowel perforation, or short bowel syndrome were excluded. Patients were divided into the early (group E; n=44) or late (group L; n=40) group according to the time of feeding commencement. Early feeding was defined as enteral feeding that started within 48 hours after surgery. Early and late feeding groups were compared with respect to clinical data and surgical outcomes.

Results

The most common cause of operation was bowel perforation, and the small bowel was the most commonly involved site. No significant intergroup differences were found for causes, sites, or types of operation. However, length of stay (LOS) in the intensive care unit (1 day vs. 2 days, p=0.038) and LOS in the hospital after surgery were significantly greater (9 days vs. 12 days, p=0.012) in group L than group E; pulmonary complications were also significantly more common (13.6% vs. 47.5%, p=0.001) in group L than group E.

Conclusion

After emergency GI surgery, early feeding may be feasible in patients without severe shock or bowel anastomosis instability.
Keywords:Emergency treatment  enteral nutrition  gastrointestinal tract
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