scholarly journals Oral Nutritional Supplements and Enteral Nutrition in Patients with Gastrointestinal Surgery

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2655
Author(s):  
Maria Wobith ◽  
Arved Weimann
Keyword(s):  
Enteral Nutrition ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gastrointestinal Surgery ◽  
Nutritional Therapy ◽  
Oral Feeding ◽  
Calorie Intake ◽  
Obese Patients ◽  
Oral Nutritional Supplements ◽  
Upper Gastrointestinal

Nowadays, patients undergoing gastrointestinal surgery are following perioperative treatment in enhanced recovery after surgery (ERAS) protocols. Although oral feeding is supposed not to be stopped perioperatively with respect to ERAS, malnourished patients and inadequate calorie intake are common. Malnutrition, even in overweight or obese patients, is often underestimated. Patients at metabolic risk have to be identified early to confirm the indication for nutritional therapy. The monitoring of nutritional status postoperatively has to be considered in the hospital and after discharge, especially after surgery in the upper gastrointestinal tract, as normal oral food intake is decreased for several months. The article gives an overview of the current concepts of perioperative enteral nutrition in patients undergoing gastrointestinal surgery.

scholarly journals The application of enhanced recovery after surgery for upper gastrointestinal surgery: Meta-analysis

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhen-Dong Huang ◽  
Hui-Yun Gu ◽  
Jie Zhu ◽  
Jie Luo ◽  
Xian-Feng Shen ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Gastrointestinal Surgery ◽  
Lung Infection ◽  
Conventional Care ◽  
Site Infection ◽  
Significant Difference ◽  
Postoperative Length ◽  
Upper Gastrointestinal

Abstract Background Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. Methods Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. Results A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection (RR = 0.50, 95%CI: 0.33 to 0.75), postoperative length of stay (MD = -2.53, 95%CI: − 3.42 to − 1.65), time until first postoperative flatus (MD = -0.64, 95%CI: − 0.84 to − 0.45) and time until first postoperative defecation (MD = -1.10, 95%CI: − 1.74 to − 0.47) in patients who received ERAS, compared to conventional care. However, other outcomes were not significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P = 0.10), surgical site infection (P = 0.42), postoperative anastomotic leakage (P = 0.45), readmissions (P = 0.31) and ileus (P = 0.25). Conclusions ERAS protocols can reduce the risk of postoperative lung infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed undergoing gastrectomy and esophagectomy.

scholarly journals The Application of Enhanced Recovery after Surgery for Upper Gastrointestinal Surgery: Meta-Analysis

2019 ◽  
Author(s):  
Zhen-Dong Huang ◽  
Hui-Yun Gu ◽  
Jie Zhu ◽  
Jie Luo ◽  
Xian-Feng Shen ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Gastrointestinal Surgery ◽  
Lung Infection ◽  
Conventional Care ◽  
Site Infection ◽  
Significant Difference ◽  
Postoperative Length ◽  
Upper Gastrointestinal

Abstract Background: Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. Methods : Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. Results : A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection ( RR =0.50, 95%CI: 0.33 to 0.75 ), postoperative length of stay ( MD =-2.53, 95%CI: -3.42 to -1.65 ) , time until first postoperative flatus ( MD =-0.64, 95%CI: -0.84 to -0.45 ) and time until first postoperative defecation ( MD =-1.10, 95%CI: -1.74 to -0.47 ) in patients who received ERAS, compared to conventional care . However, other outcomes were not significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P=0.10), surgical site infection (P=0.42), postoperative anastomotic leakage (P=0.45), readmissions (P=0.31) and ileus (P =0.25). Conclusions : ERAS protocols can reduce the risk of postoperative lung infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed undergoing gastrectomy and esophagectomy.

scholarly journals EARLY ORAL FEEDING POST-UPPER GASTROINTESTINAL TRACT RESECTION AND PRIMARY ANASTOMOSIS IN ONCOLOGY

2018 ◽  
Vol 31 (1) ◽  
Author(s):  
Lilian Pinheiro LOPES ◽  
Taysa Machado MENEZES ◽  
Diogo Oliveira TOLEDO ◽  
Antônio Talvane Torres DE-OLIVEIRA ◽  
Adhemar LONGATTO-FILHO ◽  
...  
Keyword(s):  
Enteral Nutrition ◽  
Total Gastrectomy ◽  
Primary Anastomosis ◽  
Gastrointestinal Surgery ◽  
Oral Intake ◽  
Wound Dehiscence ◽  
Oral Feeding ◽  
Oral Nutrition ◽  
Early Oral Feeding ◽  
Upper Gastrointestinal

ABSTRACT Background: The practice of starving patients in the immediate period after upper gastrointestinal surgery is widespread. Early oral intake has been shown to be feasible and may result in faster recovery and decrease length of hospital. Aim: To evaluate the feasibility and safety of oral nutrition on postoperative early feeding after upper gastrointestinal surgeries. Methods: Observational cohort design study with convenience retrospective data in both genders, over 18 years, undergoing to total gastrectomy and/or elective esophagectomy. They have received oral or enteral nutrition in less than 48 h after surgery, and among those who started with enteral nutrition, the oral feeding up to seven days. Results: The study was performed in 161 patients, 24 (14.9%) submitted to esophagectomy, 132 (82%) to total gastrectomy and five (3.1%) to esophagogastrectomy. Was observed good dietary acceptance and low percentage (29%) of gastrointestinal intolerances, more pronounced among those with enteral diet. Most of the patients did not present postoperative complications, 11 (6.8%) were reopened, five (3.1%) had fistulas, three (1.9%) wound dehiscence, three (1.9%) fistula more wound dehiscence and six (3.7%) other non-infectious complications. Conclusion: Early oral diet is safe and viable for patients undergoing upper gastrointestinal surgery.

scholarly journals Results of an Enhanced Recovery after Surgery Protocol for Upper Gastrointestinal Surgery at a Super-Tertiary Referral Hospital in Thailand

2020 ◽  
Vol 25 (5) ◽  
pp. 248
Author(s):  
Thammawat Parakonthun ◽  
Thikhamporn Tawantanakorn ◽  
Jirawat Swangsri ◽  
Tharathorn Suwatthanarak ◽  
Nicha Srisuworanan ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Gastrointestinal Surgery ◽  
Referral Hospital ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Upper Gastrointestinal

scholarly journals The Application of Enhanced Recovery after Surgery for Upper Gastrointestinal Surgery: Meta-Analysis

2019 ◽  
Author(s):  
Zhen-Dong Huang ◽  
Hui-Yun Gu ◽  
Jie Zhu ◽  
Jie Luo ◽  
Xian-Feng Shen ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Gastrointestinal Surgery ◽  
Lung Infection ◽  
Conventional Care ◽  
Site Infection ◽  
Significant Difference ◽  
Postoperative Length ◽  
Upper Gastrointestinal

Abstract Background: Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. Methods : Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. Results : A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection ( RR =0.50, 95%CI: 0.33 to 0.75 ), postoperative length of stay ( MD =-2.53, 95%CI: -3.42 to -1.65 ) , time until first postoperative flatus ( MD =-0.64, 95%CI: -0.84 to -0.45 ) and time until first postoperative defecation ( MD =-1.10, 95%CI: -1.74 to -0.47 ) in patients who received ERAS, compared to conventional care . However, other outcomes were not significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P=0.10), surgical site infection (P=0.42), postoperative anastomotic leakage (P=0.45), readmissions (P=0.31) and ileus (P =0.25). Conclusions : ERAS protocols can reduce the risk of postoperative lung infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed undergoing gastrectomy and esophagectomy.

scholarly journals The Application of Enhanced Recovery after Surgery for Upper Gastrointestinal Surgery: Meta-Analysis

2019 ◽  
Author(s):  
Zhen-Dong Huang ◽  
Hui-Yun Gu ◽  
Jie Zhu ◽  
Jie Luo ◽  
Xian-Feng Shen ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Gastrointestinal Surgery ◽  
Lung Infection ◽  
Conventional Care ◽  
Site Infection ◽  
Significant Difference ◽  
Upper Gastrointestinal

Abstract Background: Although enhanced recovery after surgery (ERAS) has made great progress in the field of surgery, the guidelines point to the lack of high-quality evidence in upper gastrointestinal surgery. Methods: Randomized controlled trials in four electronic databases that involved ERAS protocols for upper gastrointestinal surgery were searched through December 12, 2018. The primary endpoints were lung infection, urinary tract infection, surgical site infection, postoperative anastomotic leakage and ileus. The secondary endpoints were postoperative length of stay, the time from end of surgery to first flatus and defecation, and readmission rates. Subgroup analysis was performed based on the type of surgery. Results: A total of 17 studies were included. The results of the meta-analysis indicate that there was a decrease in rates of lung infection (RR =0.50, 95%CI: 0.33 to 0.75, P <0.01), PLOS (MD =-2.53, 95%CI: -3.42 to -1.65, P <0.01), time until first postoperative flatus (MD =-0.64, 95%CI: -0.84 to -0.45, P <0.01) and time until first postoperative defecation (MD =-1.10, 95%CI: -1.74 to -0.47, P <0.01) in patients who received ERAS, compared to conventional care. However, other outcomes were no significant difference. There was no significant difference between ERAS and conventional care in rates of urinary tract infection (P =0.10), surgical site infection (P =0.42), postoperative anastomotic leakage (P =0.45), readmissions (P =0.31) and ileus (P =0.25). Conclusions: ERAS protocols can reduce the risk of postoperative infection and accelerating patient recovery time. Nevertheless, we should also consider further research ERAS should be performed in elderly patients undergoing gastrectomy.

scholarly journals OC-122 Enhanced recovery after upper gastrointestinal surgery (ERAUGIS) improves outcomes in upper gastrointestinal (UGI) cancer: Abstract OC-122 Table 1

Gut ◽  
2012 ◽  
Vol 61 (Suppl 2) ◽  
pp. A53.1-A53 ◽  
Author(s):  
A J Beamish ◽  
D S Y Chan ◽  
T D Reid ◽  
R Barlow ◽  
I Howell ◽  
...  
Keyword(s):  
Enhanced Recovery ◽  
Gastrointestinal Surgery ◽  
Upper Gastrointestinal

Intra-abdominal Trocar-Free Vacuum Liver Retractor for Upper-Gastrointestinal Surgery

2017 ◽  
Vol 24 (2) ◽  
pp. 186-191 ◽  
Author(s):  
Christian Benzing ◽  
Helmut Weiss ◽  
Felix Krenzien ◽  
Matthias Biebl ◽  
Johann Pratschke ◽  
...  
Keyword(s):  
Gastrointestinal Surgery ◽  
Obese Patients ◽  
Liver Retraction ◽  
Upper Gi ◽  
Single Port Surgery ◽  
Clinical Series ◽  
Liver Retractor ◽  
Study Population ◽  
Male Patients ◽  
Upper Gastrointestinal

Background. In laparoscopic upper-gastrointestinal (GI) surgery, an adequate retraction of the liver is crucial. Especially in single-port surgery and obese patients, problems may occur during liver retraction. The current study seeks to evaluate the efficacy and safety of the LiVac trocar-free liver retractor in laparoscopic upper-GI surgery. Methods. The present study is a nonrandomized dual-center clinical series describing our preliminary results using the LiVac system for liver retraction. The primary end points of the present study included the effectiveness and safety of the LiVac device as well as complications and documentation of problems with the device during surgery. Results. The device was used in 11 patients for simple and complex laparoscopic procedures. The mean age of the study population was 59.6 years (SD = 20.6; range = 30-84). There were 6 female and 5 male patients with a mean body mass index (BMI) of 31.9 kg/m2 (SD = 8.1; range = 26.0-45.3). The efficacy of the device was excellent in all cases, reducing the number of trocars needed. There were no device-related complications. Conclusion. The LiVac liver retractor is easy to use and provides a good exposure of the operative field in upper-GI laparoscopic surgery, even in obese patients with a high BMI.

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