Intolerance to early oral feeding in enhanced recovery after colorectal surgery: an early red flag?

2019 ◽  
Vol 22 (1) ◽  
pp. 95-101 ◽  
Author(s):  
K. Slim ◽  
T. Reymond ◽  
J. Joris ◽  
S. Paul ◽  
B. Pereira ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Enhanced Recovery ◽  
Oral Feeding ◽  
Early Oral Feeding ◽  
Red Flag

scholarly journals Ordering a Normal Diet at the End of Surgery—Justified or Overhasty?

Nutrients ◽  
2018 ◽  
Vol 10 (11) ◽  
pp. 1758 ◽  
Author(s):  
Fabian Grass ◽  
Martin Hübner ◽  
Jenna Lovely ◽  
Jacopo Crippa ◽  
Kellie Mathis ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Length Of Hospital Stay ◽  
Outcome Data ◽  
Normal Diet ◽  
Oral Feeding ◽  
Prolonged Length ◽  
Early Oral Feeding ◽  
American Society ◽  
Independent Decision ◽  
Recovery Pathways

Early re-alimentation is advocated by enhanced recovery pathways (ERP). This study aimed to assess compliance to ERP-set early re-alimentation policy and to compare outcomes of early fed patients and patients in whom early feeding was withhold due to the independent decision making of the surgeon. For this purpose, demographic, surgical and outcome data of all consecutive elective colorectal surgical procedures (2011–2016) were retrieved from a prospectively maintained institutional ERP database. The primary endpoint was postoperative ileus (POI). Surgical 30-day outcome and length of stay were compared between patients undergoing the pathway-intended early re-alimentation pattern and patients in whom early re-alimentation was not compliant. Out of the 7103 patients included, 1241 (17.4%) were not compliant with ERP re-alimentation. Patients with delayed re-alimentation presented with more postoperative complications (37 vs. 21%, p < 0.001) and a prolonged length of hospital stay (8 ± 7 vs. 5 ± 4 days, p < 0.001). While male gender (odds ratio (OR) 1.24; 95% confidence interval (CI) 1.04–1.32), fluid overload (OR 1.38; 95% CI 1.16–1.65) and high American Society of Anaesthesiologists (ASA) score (OR 1.51; 95% CI 1.27–1.8) were independent risk factors for POI, laparoscopy (OR 0.51; 95% CI 0.38–0.68) and ERP compliant diet (OR 0.46; 95% CI 0.36–0.6) were both protective. Hence, this study provides further evidence of the beneficial effect of early oral feeding after colorectal surgery.

scholarly journals Impact of Enhanced Recovery after Surgery with Preoperative Whey Protein-Infused Carbohydrate Loading and Postoperative Early Oral Feeding among Surgical Gynecologic Cancer Patients: An Open-Labelled Randomized Controlled Trial

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 264 ◽  
Author(s):  
Ho Chiou Yi ◽  
Zuriati Ibrahim ◽  
Zalina Abu Zaid ◽  
Zulfitri ‘Azuan Mat Daud ◽  
Nor Baizura Md. Yusop ◽  
...  
Keyword(s):  
Whey Protein ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gynecologic Cancer ◽  
Intervention Group ◽  
Oral Feeding ◽  
Control Group ◽  
Early Oral Feeding ◽  
Significant Difference ◽  
The Impact

Enhanced Recovery after Surgery (ERAS) with sole carbohydrate (CHO) loading and postoperative early oral feeding (POEOF) shortened the length of postoperative (PO) hospital stays (LPOHS) without increasing complications. This study aimed to examine the impact of ERAS with preoperative whey protein-infused CHO loading and POEOF among surgical gynecologic cancer (GC) patients. There were 62 subjects in the intervention group (CHO-P), which received preoperative whey protein-infused CHO loading and POEOF; and 56 subjects formed the control group (CO), which was given usual care. The mean age was 49.5 ± 12.2 years (CHO-P) and 51.2 ± 11.9 years (CO). The trial found significant positive results which included shorter LPOHS (78.13 ± 33.05 vs. 99.49 ± 22.54 h); a lower readmission rate within one month PO (6% vs. 16%); lower weight loss (−0.3 ± 2.3 kg vs. −2.1 ± 2.3 kg); a lower C-reactive protein–albumin ratio (0.3 ± 1.2 vs. 1.1 ± 2.6); preserved muscle mass (0.4 ± 1.7 kg vs. −0.7 ± 2.6 kg); and better handgrip strength (0.6 ± 4.3 kg vs. −1.9 ± 4.7 kg) among CHO-P as compared with CO. However, there was no significant difference in mid-upper arm circumference and serum albumin level upon discharge. ERAS with preoperative whey protein-infused CHO loading and POEOF assured better PO outcomes.

scholarly journals Is Early Oral Feeding Safe After Elective Colorectal Surgery? A Prospective Randomized Trial

1995 ◽  
Vol 222 (1) ◽  
pp. 73-77 ◽  
Author(s):  
Petachia Reissman ◽  
Tiong-Ann Teoh ◽  
Stephen M. Cohen ◽  
Eric G. Weiss ◽  
Juan J. Nogueras ◽  
...  
Keyword(s):  
Colorectal Surgery ◽  
Randomized Trial ◽  
Oral Feeding ◽  
Prospective Randomized Trial ◽  
Elective Colorectal Surgery ◽  
Early Oral Feeding

Enforced mobilization, early oral feeding, and balanced analgesia improve convalescence after colorectal surgery

Nutrition ◽  
2002 ◽  
Vol 18 (2) ◽  
pp. 147-152 ◽  
Author(s):  
M.G Henriksen ◽  
M.B Jensen ◽  
H.V Hansen ◽  
T.W Jespersen ◽  
I Hessov
Keyword(s):  
Colorectal Surgery ◽  
Oral Feeding ◽  
Early Oral Feeding ◽  
Balanced Analgesia

Safety and efficacy of early oral feeding for enhanced recovery following gastrectomy for gastric cancer: A systematic review

2019 ◽  
Vol 28 ◽  
pp. 88-95 ◽  
Author(s):  
Thaís Tweed ◽  
Yara van Eijden ◽  
Juul Tegels ◽  
Hylke Brenkman ◽  
Jelle Ruurda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Enhanced Recovery ◽  
Oral Feeding ◽  
Safety And Efficacy ◽  
Early Oral Feeding

scholarly journals Early oral feeding after colorectal surgery: A mixed methods study of knowledge translation

2018 ◽  
Vol 75 (4) ◽  
pp. 345-352 ◽  
Author(s):  
Tayla R. Robertson ◽  
Naomi E. Eldridge ◽  
Megan E. Rattray ◽  
Shelley J. Roberts ◽  
Ben Desbrow ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Colorectal Surgery ◽  
Knowledge Translation ◽  
Oral Feeding ◽  
Mixed Methods Study ◽  
Early Oral Feeding

scholarly journals ENHANCED RECOVERY (ERAS) AFTER LIVER SURGERY:COMPARATIVE STUDY IN A BRAZILIAN TERCIARY CENTER

2019 ◽  
Vol 32 (1) ◽  
Author(s):  
Uirá Fernandes TEIXEIRA ◽  
Marcos Bertozzi GOLDONI ◽  
Fábio Luiz WAECHTER ◽  
José Artur SAMPAIO ◽  
Florentino Fernandes MENDES ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Surgical Stress ◽  
Length Of Hospital Stay ◽  
Early Mobilization ◽  
Oral Feeding ◽  
Control Group ◽  
Colonic Surgery ◽  
Early Oral Feeding ◽  
Tertiary Center ◽  
Eras Protocol

ABSTRACT Background: After the publication of the first recommendations of ERAS Society regarding colonic surgery, the proposal of surgical stress reduction, maintenance of physiological functions and optimized recovery was expanded to other surgical specialties, with minimal variations. Aim: To analyze the implementation of ERAS protocols for liver surgery in a tertiary center. Methods: Fifty patients that underwent elective hepatic surgery were retrospectively evaluated, using medical records data, from June 2014 to August 2016. After September 2016, 35 patients were prospectively evaluated and managed in accordance with ERAS protocol. Results: There was no difference in age, type of hepatectomy, laparoscopic surgery and postoperative complications between the groups. In ERAS group, it was observed a reduction in preoperative fasting and in the length of hospital stay by two days (p< 0.001). Carbohydrate loading, j-shaped incision, early oral feeding, postoperative prevention of nausea and vomiting and early mobilization were also significantly related to ERAS group. Oral bowel preparation, pre-anesthetic medication, sub-costal incision, prophylactic nasogastric intubation and abdominal drainage were more common in control group. Conclusion: Implementation of ERAS protocol is feasible and beneficial for health institutions and patients, without increasing morbidity and mortality.

scholarly journals The nutritional management of surgical patients: enhanced recovery after surgery

2003 ◽  
Vol 62 (4) ◽  
pp. 807-811 ◽  
Author(s):  
Kenneth C. H. Fearon ◽  
Rachel Luff
Keyword(s):  
Enhanced Recovery ◽  
Elective Surgery ◽  
Rectal Surgery ◽  
Oral Feeding ◽  
Morbidity And Mortality ◽  
Surgical Trauma ◽  
Early Recovery ◽  
Oral Nutrition ◽  
Operative Morbidity ◽  
Early Oral Feeding

Malnutrition has long been recognised as a risk factor for post-operative morbidity and mortality. Traditional metabolic and nutritional care of patients undergoing major elective surgery has emphasised pre-operative fasting and re-introduction of oral nutrition 3–5 d after surgery. Attempts to attenuate the consequent nutritional deficit and to influence post-operative morbidity and mortality have included parenteral, enteral and oral sip feeding. Recent studies have emphasised that an enhanced rate of recovery can be achieved by a multi-modal approach focused on modulating the metabolic status of the patient before (e.g. carbohydrate and fluid loading), during (e.g. epidural anaesthesia) and after (e.g. early oral feeding) surgery. Using such an approach preliminary results on patients undergoing elective colo-rectal surgery indicate a significant reduction in hospital stay (traditional care, n 48, median stay 10 d v. enhanced recovery programme, n 33, median stay 7d; P<0·01) can be achieved. Such findings emphasise the potential role of multi-modal care programmes in the promotion of early recovery from major surgical trauma.

scholarly journals Short-term outcome after cystectomy: comparison of early oral feeding in an enhanced recovery protocol and feeding using Bengmark nasojejunal tube

2017 ◽  
Vol 36 (2) ◽  
pp. 221-229 ◽  
Author(s):  
C. S. Voskuilen ◽  
E. E. Fransen van de Putte ◽  
J. Bloos-van der Hulst ◽  
E. van Werkhoven ◽  
W. M. de Blok ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Oral Feeding ◽  
Short Term ◽  
Term Outcome ◽  
Early Oral Feeding ◽  
Short Term Outcome ◽  
Nasojejunal Tube ◽  
Enhanced Recovery Protocol
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