Document Detail


A comparison of the effectiveness of the early enteral and natural nutrition after pancreatoduodenectomy.
MedLine Citation:
PMID:  18971605     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The role of postoperative supplementary enteral nutrition after gastrointestinal surgery is controversial. Therefore, a randomized clinical trial with attempts to address the question of plenitude of routine application of postoperative enteral feeding on rate of postoperative complications following pancreatoduodenectomy was performed. Sixty patients undergoing pancreatoduodenectomy were blindly randomized into two groups: 30 patients in the first group received early enteral nutrition (EEN), while 30 patients in the second group were given early natural nutrition (ENN). The complications were evaluated according to definition criteria. All complications were further subdivided into infectious and noninfectious complications. Our data showed that patients in EEN group gained a larger amount of energy in kcal a day during the first five days after surgery in comparison to ENN group. There was a higher rate of postoperative complications in ENN group (53.3% vs 23.3%, P=0.03). This difference occurred mainly due to the higher incidence of infectious complications in ENN group (46.7% vs 16.7%, P=0.025). There were six cases of bacteriemia in this group of patients, while only one case was observed in EEN group (6 (20.0%) vs 1 (3.3%), P=0.1). The overall risk for the development of any type of infectious complication was 1.5 times higher in ENN group. In conclusion, this study suggests that supplementary postoperative enteral nutrition helps to decrease the rate of infectious complications in patients undergoing pancreatoduodenectomy, especially in those with a plasma albumin level of less than 34.5 g/L and/or ASA class III or higher, since natural nutrition is insufficient in this case.
Authors:
Saulius Grizas; Antanas Gulbinas; Giedrius Barauskas; Juozas Pundzius
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Medicina (Kaunas, Lithuania)     Volume:  44     ISSN:  1648-9144     ISO Abbreviation:  Medicina (Kaunas)     Publication Date:  2008  
Date Detail:
Created Date:  2008-10-30     Completed Date:  2008-11-24     Revised Date:  2013-05-20    
Medline Journal Info:
Nlm Unique ID:  9425208     Medline TA:  Medicina (Kaunas)     Country:  Lithuania    
Other Details:
Languages:  eng     Pagination:  678-86     Citation Subset:  IM    
Affiliation:
Department of Surgery, Kaunas University of Medicine, Kaunas, Lithuania. sgrizas@kol.medi.lt
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MeSH Terms
Descriptor/Qualifier:
Aged
Clinical Protocols
Data Interpretation, Statistical
Energy Intake
Enteral Nutrition*
Female
Gastric Emptying
Humans
Incidence
Infection / epidemiology
Male
Middle Aged
Nutritional Physiological Phenomena*
Pancreaticoduodenectomy*
Postoperative Care*
Postoperative Complications / blood,  epidemiology*
Risk Factors
Serum Albumin / analysis
Statistics, Nonparametric
Time Factors
Chemical
Reg. No./Substance:
0/Serum Albumin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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