EARLY FEEDING VERSUS LATE FEEDING IN PATIENTS UNDERGOING GASTROINTESTINAL EMERGENCY SURGERIES IN TERTIARY CARE CENTER: RANDOMIZED-CONTROL OBSERVATIONAL STUDY
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Abstract
BACKGROUND:As per the routine protocol followed in most of the hospitals even now is keeping the patient nil by mouth till the function of the intestines are regained. But the recent evidence based studies have shown that initiating enteral feeding in early post-operative period is beneficial to the patient and also gives patient a necessary push to recovery by both means I.e, metabolically and immunologically.
AIMS & OBJECTIVE:This observational study is done to evaluate the outcomes of the patients who under went emergency gastro intestinal surgery by providing enteral nutrition within 24-48 hours of surgery compared with conventional delayed approach
MATERIAL & METHODS:The study conducted between June 2022 to June 2024 is a randomised control prospective study done in a tertiary care hospital. The study included all the gastrointestinal emergencies in which patient were operated for hollow viscus perforation, intestinal obstruction and obstructed hernia.
RESULTS:Mean age of the study group was 44.87 years with 20% cases being less than 40 years and 62.9% and 17.1% in their fifth and sixth decade respectively. Out of total 70 cases, 43 (61.4%) were males and 27 (38.6%) were females. Most common indication for surgery was hemicolectomy (24.3%) and small bowel resection (17.10%). Mean duration of ileus was significantly more in cases of delayed feeding (5.6 vs 4.23 days).Overall complication rate was significantly more in cases with delayed feeding (20% vs 5.7%; p<0.05). GI reactions (14.3% vs 5.7%), wound infections (11.4% vs 2.9%) and rate of anastomotic leak (8.6% vs 0%) were observed to be higher with delayed feeding group.
CONCLUSION:Present study showed that early feeding after bowel surgery has better outcome than delayed feeding in terms of lower complications like anastomotic leak and wound infections. Early feeding was equally well tolerated by patients and enables shorter length of hospital stay, leading to lower cost of treatment. However, we need a larger multi-centric study to demonstrate statistically significant difference in the outcomes to further validate the study findings.
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Sagar Kannavar
Associate Professor Department Of General Surgery S S Institute of Medical Sciences,
Mahendra Reddy GS
Fellow, department of surgical gastroenterology, I got Bengaluru,
Dinesh L Jadhav
Professor, III Year Postgraduate, Department Of General Surgery S S Institute of Medical Sciences, Davangere, Karnataka India
Panindra Pilli
Professor, III Year Postgraduate, Department Of General Surgery S S Institute of Medical Sciences, Davangere, Karnataka India