Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery: a meta-analysis

Osland, Emma and Yunus, Rossita Mohamad and Khan, Shahjahan and Memon, Muhammed Ashraf (2011) Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery: a meta-analysis. Journal of Parenteral and Enteral Nutrition, 35 (4). pp. 473-487. ISSN 0148-6071

Abstract

Background: A meta-analysis evaluating surgical outcomes following nutritional provision provided proximal to the anastomosis within 24 hours of gastrointestinal surgery compared with traditional postoperative management was conducted. Methods: Databases were searched to identify randomized controlled trials comparing the outcomes of early and traditional postoperative feeding. Trials involving gastrointestinal tract resection followed by patients receiving nutritionally significant oral or enteral intake within 24 hours after surgery were included for analysis. Results: Fifteen studies involving a total of 1240 patients were analyzed. A statistically significant reduction (45%) in relative odds of total postoperative complications was seen in patients receiving early postoperative feeding (odds ratio [OR] 0.55; confidence interval [CI], 0.35 -0.87, P = .01). No effect of early feeding was seen with relation to anastomotic dehiscence (OR 0.75; CI, 0.39-1.4, P = .39), mortality (OR 0.71; CI, 0.32-1.56, P = .39), days to passage of flatus (weighted mean difference [WMD] -0.42; CI, -1.12 to 0.28, P = .23), first bowel motion (WMD -0.28; CI, -1.20 to 0.64, P = .55), or reduced length of stay (WMD -1.28; CI, -2.94 to 0.38, P = .13); however, the direction of clinical outcomes favored early feeding. Nasogastric tube reinsertion was less common in traditional feeding interventions (OR 1.48; CI, 0.93-2.35, P = .10). Conclusions: Early postoperative nutrition is associated with significant reductions in total complications compared with traditional postoperative feeding practices and does not negatively affect outcomes such as mortality, anastomotic dehiscence, resumption of bowel function, or hospital length of stay.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Permanent restricted access to published version due to publisher copyright policy.
Depositing User: Professor Shahjahan Khan
Faculty / Department / School: Historic - Faculty of Sciences - Department of Maths and Computing
Date Deposited: 14 May 2012 22:53
Last Modified: 23 Jul 2014 01:15
Uncontrolled Keywords: early feeding; hospitalization; meta-analysis; patient outcome; postoperative complications; randomized controlled trials; resectional gastrointestinal surgery; traditional feeding
Fields of Research (FOR2008): 11 Medical and Health Sciences > 1103 Clinical Sciences > 110307 Gastroenterology and Hepatology
11 Medical and Health Sciences > 1103 Clinical Sciences > 110323 Surgery
11 Medical and Health Sciences > 1111 Nutrition and Dietetics > 111199 Nutrition and Dietetics not elsewhere classified
Socio-Economic Objective (SEO2008): C Society > 92 Health > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920105 Digestive System Disorders
Identification Number or DOI: doi: 10.1177/0148607110385698
URI: http://eprints.usq.edu.au/id/eprint/21268

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