Enteral Feeding After Gastric Intestinal Resection

Enteral Feeding After Gastric enteric ResectionOptimum nutrition has always been a major target of seat operant care. Ileus is a common phenomenon later group AB operation, thus archeozoic oral feeding is avoided and nasogastric decompression is being drilld. Conventionally, attitude abdominal muscle surgery, the exit of flatus, or intestine movement was the clinical evidence of starting signal an oral diet. The end of post operative ileus based to be taken by the passage of flatus usually occurred within 5 days. The many studies have proved that the routine use of a nasogastric furnish after abdominal Surgery and colorectal surgery may not be necessary. studies were undertaken to evaluate /whether different abdominal surgeries could benefit from early feeding. betimes feeding improves the outcome of the patients with trauma and Burns although few studies have examined its use after gastro intestinal anastomosis. In case of laparoscopic colectomy patients have been fed routinely on day 2 after operation and that is being safely tolerated by the majority of patients.There are many evidences which indicate that present(prenominal) feeding after operation is actually feasible and safe whether post laparoscopic or post laparotomy , including gastro intestinal surgery. It has been proved by many studies that early enteral feeding in operative patients improves nutrition and immunity and last reducing septic complications and over all morbidity when compared with parenteral nutrition.A study conducted that compared an early regular diet to conventional post operative dietary management to determine G1 complications and mortality after major G1 anastomosis.The objective of this study was to assess the safety and tolerability outcomes of early oral feeding after elective gastro intestinal anastomosis.Patients and MethodsBetween July 2006 and December 2009, after the study was sanctioned by ethical review committee, patients were offered participation and informed consent taken. Patients with continuing liver disease or those with metastasis and patients with histories of penetrating obstruction, perforation and intra abdominal infection were excluded. Patients were exposed to a thorough history, physical examination and investigations.The patients were then randomized into ii groups. Randomization done victimisation sealed envelopes.Group 1(Early feeding) 30 patients were offered simply a limpid diet within 6 hours of comer on the ward. If 1 liter was being tolerated they were free for free liquid on the second day and then regular diet on the third day. (Tolerance is being indicated by an absence of vomiting or abdominal distension).Group 2(Regular feeding) 30 patients were managed conventionally (that is nothing by speak until the resolution of ileus, then a fluid diet, followed by regular diet. on the whole patients underwent general anesthesia no nasogastric tube was inserted in any patients during surgery in patients in group 1 and a nasogastric tube was inserted in all patients during surgery and continued till the resolution of ileus in group 2.The patients were monitored for vomiting, abdominal distension duration of ileus, tolerance of regular diet, length of hospitalization and complications.If there were two episodes of vomiting in the absence of gut sounds or passage of flatus in the absence of any bowel movement, insertion of nasogastric tube was implemented.Also those who suffered from abdominal distension, emesis and succussion splash of stomach were diagnosed with acute dilatation of stomach, subjected to G I decompression. If there was anastomosis failure, treatment ensued such as antibiotics, nutritional support, ileostomy or colostomy.Patients with normal post operative railway line were discharged when they could tolerate a regular diet.Demographics were age and sex, medical and surgical histories of the patients and indications for anastomosis were noted. Different patients h ad different types of anastomosis were randomly allocated to group 1 irrespective of anastomotic type to eliminate bias. Table 1.Indications group 1 group 2Tuberculous 5 5Stricture atIleumClosure of 20 20IleostomyColorectal surgery 5 5The main outcome was to evaluate post operative complications that included insult infection, leakage of anastomosis, obstruction, mesenteric emboli, upper G1 bleeding, wound dehiscence, prolonged ileus, and mortality. Ileus was specify as hypoactive bowel sounds, abdominal distension and no passage of flatus or bowel movement with or without nausea or vomiting after the first post operative day 3.statistical analysis of data done by SPSS version 10. For continuous variables, descriptive statistics were calculated and were reported as mean +SD. Categorical variables were described using frequency distribution. The student T-test for paired samples was used to detect difference in the mean of continuous variables and the chi-square test was used in ca ses with low judge frequencies (a P value