الفهرس | Only 14 pages are availabe for public view |
Abstract Gut anastomosis is one of the frequently performed surgeries in both emergency and elective setup . early feeding after gastrointestinal anastomosis is safe and is more physiological as well as prevents morphologic and functional trauma-relatedalterationsof the gut . This study was conducted to compare feasibility, safety and efficacy of early versus late Enteral Nutrition after gastrointestinal anastmosis surgery concerning : duration of hospitalstay, ease of Recovery.and incidence of Complications. Thirty patients were operated upon by different abdominalsurgicalprocedures which include small or large intestine anastomosis on emergency or elective issues. Post-operative: In early feeding group: early postoperative enteral feedingstartedafter24hoursofsurgeryorjustafterremovalofnasogasterictube . In late feeding group, the enteral feedingstarted in traditional method regaining bowel sounds, absence of distention, passage of flatus or stool. Our resultsrevealed: • No statistically significant difference betweenearlyfeedingand latefeeding regarding demographic data, the mean age was 47.50years in earlyfeeding, 42.75 years in late feeding. Mean BMI was 30.29 years in early feeding. 31.00 in late feeding. Male to female ratio was 1:1. • Nostatisticallysignificantdifferencebetweenearlyfeedingandlate feeding regarding history.Both groupswere non diabetic non hypertensive andno ischemic heart disease. • Nostatisticallysignificantdifferencebetweenearlyfeedingandlatefeeding regardingcomplicationsas abdominaldistension,vomitingorfever. Abdominal distension was observed in 28.6% in early feedingand43.8% in late feeding, vomiting was observed in 50.0% in early feeding and in 62.5% in late feeding. Fever was observed in57.1%inearlyfeeding and75.0%inlatefeeding. • Statistically significant increase in Day of NGT removal and Duration of hospitalization in late feeding. Duration of hospitalization was 5.71 days in early feeding and 7.94 days in late feeding. • No statistically significant difference between early feeding and late feeding regarding type of resection: • No statistically significant difference between early feeding and late feeding regardingblood loss and blood transfusion. Amountofbloodlosswas 288.57 ± 84.66 in early feeding and 263.75 ± 78.05 inlate feeding with blood transfusion in28.6% of patients in early feeding and in 18.8% in late feeding. • Non significant increase in albumin in early feeding group (3.79) comparedto late feeding (3.50). • Statisticallysignificanthypokalemiainlatefeeding:Klevelwas 3.9inearlyfeedingand3.4inlatefeeding. • No statistically significant difference between early feeding and late feeding among anastomotic leakage, surgical site infection and need of ICU. Anastomoticleakage0.0%inearlyfeeding6.2%inlatefeeding, surgical site infection 21.4%in early feeding and50.0% in late feeding and theneed ofICUin35.7%in early feedingand 43.8% in late feeding. • No statistically significant difference between earlyfeeding and latefeeding regarding deal With Complications. • Significant decrease in the need for ICU between the early feeding group which represent 35.7% in early feeding and 43.8% ofcases inlatefeeding. • no statistically significant difference between early feeding and late feeding among time of presence of intestinal sounds and time of passage flatus or stool. We observed return of bowel sounds after 2.57 days in early feeding and after 3.06 days in late feeding. Conclusion: we observed that significant decrease in Day of NGT removal and Duration of hospitalization in early postoperative feeding after gastrointestinal anastomosis surgery could be attributed to decreasedcomplicationsand improve gut motilityand healing. |