Vol. 5, Issue 10 (2019)
Effect of early enteral feeding versus nill by mouth after gastrointestinal surgery
Author(s): Dr. Md Aminur Rahman, Dr. AB M Khurshid Alam, Dr. Dewan Hasan, Dr. Shariar Rahman
Abstract: Background: The purpose of the study was to compare between early and traditional feeding after gastro intestinal surgery during 24 months of study period. 60 patients were selected to compare for early and traditional feeding after gastro intestinal (GIT) surgery. They were followed up under two groups. Traditional feeding group (Group-I, 30 patients) & early feeding (group II. 30 patients). There were no statistically significant variations in age, sex, body weight, average haemoglobin level, antibiotic, suture material used in both groups. General Objectives: To evaluate the early enteral feeding than nil by mouth following gastrointestinal surgery on the improvement of nutritional status and reduce wound complications. Specific Objective: To list the numbers of wound complications & list the numbers of anastomosis leakage. Study design: Prospective comparative study. Period of study: From July’ 2007 to June’ 2009. Place of study: Department of Surgery, Sher-E-Bangla Medical College Hospital. Sample Size: Sixty post-operative abdominal surgical cases which were undergone small gut and large gut resection and anastomosis. Methods: Detailed information’s were obtained in each cases according to protocol. Complete history was taken either from patient or accompanying attendants and thorough clinical examination was done. Relevant investigations reports were collected. All the information was recorded according to protocol. Collected data was classified, edited, coded and entered into the computer for statistical analysis by using SPSS version-11. Outcome Variables: 1. to detect wound infections 2. to detect anastomotic leakage of gut 3. to detect the duration of hospital stay. Results: Age distribution revealed that among the 60 cases of the study population among traditional feeding group 06 patients (20%) were 30-40 years age group, 09 patients (30%) were 41-50 years age group, 15 patients (50%) were 51-60 years age group. In early feeding group 07 patients (23.3%) were 30-40 years age group, 15 patients (50%) were 41-50 years age group and 08 patients (26.7%) were 51-60 years age group. Traditional feeding group male were 18patients (60%) and female were 12 patients (40%). In early feeding group male were 19 patients (63.3%) and female were 11 patients (36.7%). (p>0.05) that was not statistically significant. Traditional feeding group large gut were 10 patients (33.3%) and early feeding group were 13 patients (43.3%). (p>0.05) that was not statistically significant. Small gut operations in traditional feeding group were 20 patients (66.7%) and early feeding group were 17 patients (56.7%). (p>0.05) that was not statistically significant. In traditional feeding group : wound infection were 05 patients (16.7%) and Wound dehiscence were 02 patients (6.7%), Leakage of anastomotic site were 1patient(3.3%) and Respiratory Tract Infection (RTI) were 1 patient (3.3%). In early feeding group; Wound infection were 02 patients (6.7%), wound dehiscence nil, anastmosis leakage nil, respiratory tract infection nil. Total postoperative complications: In traditional feeding group were 09 patients (30%) and in early feeding group were 02 patients (6.7%) p<0.05 that was statistically significant. Mean nasogastric tube removal in traditional feeding group were 3.46 days and early feeding group were 2.1 days (p<0.05) that was statistically significant. Mean hospital stay in traditional feeding group were 8.26 days and early feeding group were 6.53 days (p<0.05) that was statistically significant. Conclusion: From present study it can be concluded that early oral feeding may become a routine feature of management after gastrointestinal surgery. This study reveals that early oral feeding in the patient who has under gone gastrointestinal surgery is safe.