Journal List > Korean J Gastroenterol > v.58(6) > 1006888

Lee, Shim, Lee, Lee, and Kim: The Safety of Early Enteral Feeding after Emergency Gastrointestinal Surgery

Abstract

Background/Aims

Postoperative early feeding has many advantages, and current guidelines recommend the early diet or enteral feeding after gastrointestinal surgery. However, there are controversies in emergency situation. The aim of this study was to assess the safety of early enteral feeding in patients underwent emergency gastrointestinal (GI) surgery.

Methods

We reviewed the patients underwent emergency GI surgery by single surgeon from March 2008 to December 2010, retrospectively. The early feeding was defined when feeding was started within 72 hours after operation.

Results

Fifty-three patients were enrolled. Men were 31, with mean 60.6 (±18.5) years old age. Thirty-three patients were treated in the intensive-care unit after operation. The most common cause of operation was bowel perforation, and followed by intestinal obstruction. Segmental resection with primary anastomosis of small bowel is the most common operation. Thirty-two of them started the diet within 48 hours postoperatively. Twenty-nine patients had post-operative complications. Wound complications were the most common, and followed by the abdominal pain, and ileus. Wound complications were developed in 18 patients, and the post-feeding abdominal pain was in 7 patients. Anastomotic leakage and intraabdominal abscess were developed in 2 patients, and 1 patient required reoperation to treat the anastomotic disruption. One patient developed pneumonia and sepsis, and resolved under conservative treatment. There was no mortality in these patients.

Conclusions

Early enteral feeding may be safe in cases of emergency GI surgery. However, it may require further studies to confirm the safety and feasibility of the early feeding in emergency situations.

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Fig. 1.
Starting days (A) and routes of feeding (B).
kjg-58-318f1.tif
Fig. 2.
Complications of early feeding after emergency gastrointestinal surgery.
kjg-58-318f2.tif
Table 1.
Causes of the Operations
Cause n (%)
Perforation 23 (43.4)
Obstruction/strangulation 19 (35.8)
Trauma/bleeding 6 (11.3)
Appendicitis a 5 (9.4)

a Performed ileocecectomy.

Table 2.
Types of the Operation Methods
Operation method n (%)
Small bowel segmental resection+ anastomosis 21 (39.6)
Colon resection+ anastomosis 11 (20.8)
Bypass surgery 8 (15.1)
Colon resection+ colostomy 7 (13.2)
Small bowel segmental resection+ ileostomy 3 (5.6)
Gastrectomy 3 (5.6)
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