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Journal of Gastrointestinal Surgery

Published in:

01-03-2009 | review article

Early Enteral Nutrition Within 24 h of Intestinal Surgery Versus Later Commencement of Feeding: A Systematic review and Meta-analysis

Authors: Stephen J. Lewis, Henning K. Andersen, Steve Thomas

Published in: Journal of Gastrointestinal Surgery | Issue 3/2009

Abstract

Background

We set out to evaluate early commencement of post-operative enteral nutrition versus traditional management in patients undergoing gastrointestinal surgery.

Methods

Electronic databases were searched, references lists were scanned and authors contacted for additional information. We looked for randomised controlled trials comparing early commencement of feeding (within 24 h) with no feeding in patients undergoing gastrointestinal surgery. Primary endpoints were wound infections, intra-abdominal abscesses, pneumonia, anastomotic leakage, mortality, length of hospital stay and complications of feeding. Data were combined to estimate the common relative risk of post-operative complications and associated 95% confidence intervals.

Results

Thirteen trials, with a total of 1,173 patients, fulfilled our inclusion criteria. Mortality was reduced with early post-operative feeding. Early post-operative feeding increased vomiting. The direction of effect is suggestive of a reduction of risk of post-surgical complications and reduced length of hospital stay.

Conclusion

There is no obvious advantage in keeping patients ‘nil by mouth’ following gastrointestinal surgery. Early enteral nutrition is associated with reduced mortality, though the mechanism is not clear. This review supports the notion that early commencement of enteral feeding may be of benefit.

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Title: Early Enteral Nutrition Within 24 h of Intestinal Surgery Versus Later Commencement of Feeding: A Systematic review and Meta-analysis
Authors: Stephen J. Lewis
Henning K. Andersen
Steve Thomas
Publication date: 01-03-2009
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 3/2009
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-008-0592-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Early Enteral Nutrition Within 24 h of Intestinal Surgery Versus Later Commencement of Feeding: A Systematic review and Meta-analysis

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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