Early enteral feeding after upper digestive tract surgeries and clinical assessment of post-operative ileus

Abstract

Background & Aims: In general, feeding after a gastrointestinal surgery should only occur after resolution of the post-operative ileus. However, early enteral feeding has shown such advantages (i) as faster recovery of the gastrointestinal motility, (ii) a shorter hospital stay and (iii) a better nitrogen balance. Our aim is to demonstrate that early feeding does provide these advantages and is also tolerable. Methods: The patients submitted to surgeries of the upper digestive tract were randomly distributed in two groups: the control group, with oral feeding 72h after surgery, and the test group with enteral feeding through a nasojejunal catheter 24h after surgery. The following were assessed: abdominal diameter, abdominal aspect, bowel sounds, flatulence and stools elimination, presence or absence of reflux, diarrhoea, abdominal pain, nauseas and/or vomits, all of which on a daily basis. On the fourth post-operative day, the nitrogen balance was assessed for all patients. The date of discharge from hospital was also recorded. Results: Patients in both the test group (8) and the control group (8) did not show any difference as to the period of hospital stay, recovery time of post-operative ileus and diet tolerance. The nitrogen balance was statistically significant (p<0.000) and better in the test group. Conclusions: Early enteral feeding after surgeries of the upper digestive tract is tolerable and enables a better nitrogen balance.