Ordering a Normal Diet at the End of Surgery-Justified or Overhasty?

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_5AE5749F4CF5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Ordering a Normal Diet at the End of Surgery-Justified or Overhasty?
Journal
Nutrients
Author(s)
Grass F., Hübner M., Lovely J.K., Crippa J., Mathis K.L., Larson D.W.
ISSN
2072-6643 (Electronic)
ISSN-L
2072-6643
Publication state
Published
Issued date
14/11/2018
Peer-reviewed
Oui
Volume
10
Number
11
Pages
E1758
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Early re-alimentation is advocated by enhanced recovery pathways (ERP). This study aimed to assess compliance to ERP-set early re-alimentation policy and to compare outcomes of early fed patients and patients in whom early feeding was withhold due to the independent decision making of the surgeon. For this purpose, demographic, surgical and outcome data of all consecutive elective colorectal surgical procedures (2011⁻2016) were retrieved from a prospectively maintained institutional ERP database. The primary endpoint was postoperative ileus (POI). Surgical 30-day outcome and length of stay were compared between patients undergoing the pathway-intended early re-alimentation pattern and patients in whom early re-alimentation was not compliant. Out of the 7103 patients included, 1241 (17.4%) were not compliant with ERP re-alimentation. Patients with delayed re-alimentation presented with more postoperative complications (37 vs. 21%, p < 0.001) and a prolonged length of hospital stay (8 ± 7 vs. 5 ± 4 days, p < 0.001). While male gender (odds ratio (OR) 1.24; 95% confidence interval (CI) 1.04⁻1.32), fluid overload (OR 1.38; 95% CI 1.16⁻1.65) and high American Society of Anaesthesiologists (ASA) score (OR 1.51; 95% CI 1.27⁻1.8) were independent risk factors for POI, laparoscopy (OR 0.51; 95% CI 0.38⁻0.68) and ERP compliant diet (OR 0.46; 95% CI 0.36⁻0.6) were both protective. Hence, this study provides further evidence of the beneficial effect of early oral feeding after colorectal surgery.
Keywords
Adult, Aged, Diet, Digestive System Surgical Procedures/adverse effects, Female, Humans, Male, Middle Aged, Postoperative Complications, Postoperative Period, Retrospective Studies, Risk Factors, colorectal, enhanced recovery, nutrition
Pubmed
Web of science
Open Access
Yes
Create date
20/11/2018 9:18
Last modification date
20/08/2019 15:13
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