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

Osland, Emma, Yunus, Rossita Mohamad, 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: 473-487. doi:10.1177/0148607110385698


Author Osland, Emma
Yunus, Rossita Mohamad
Khan, Shahjahan
Memon, Muhammed Ashraf
Title Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery:a meta-analysis
Journal name Journal of Parenteral and Enteral Nutrition   Check publisher's open access policy
ISSN 0148-6071
1941-2444
Publication date 2011
Sub-type Article (original research)
DOI 10.1177/0148607110385698
Open Access Status
Volume 35
Issue 4
Start page 473
End page 487
Total pages 15
Place of publication Thousand Oaks, CA, United States
Publisher Sage
Language eng
Formatted 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.
Keyword Early feeding
Hospitalization
Meta-analysis
Patient outcome
Postoperative complications
Randomized controlledtrials
Resectional gastrointestinal surgery
Traditional feeding
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Human Movement and Nutrition Sciences Publications
 
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