Postoperative Enteral Nutrition Support Research Articles

The influence of Nutren on postoperative nutritional status, inflammation and incision healing in patients with colon cancer

To explore the impact of Nutren on postoperative nutritional status, incision healing and inflammation in patients with colon cancer (CC). Division of 94 patients with CC as the research object was into the observation group (51 cases) and the control (43 cases) on the grounds of postoperative enteral nutrition support (ENS). Analysis of the influence of Nutren on postoperative nutritional status, inflammation and incision healing was performed. No distinct differences between the two groups in surgical efficacy, survival rate, distant metastasis rate and recurrence rate after surgery of 2 years (P > 0.05); The incision healing time of the observation was shorter versus the control, and the incision healing was superior versus the control. Hemoglobin, albumin and total plasma protein of 14 d after operation were elevated versus the control, and c-reactive protein (CRP), tumor necrosis factor-α (TNF-α), and interleukin (IL)-6 were declined versus the control (P < 0.05). Giving of enteral nutrition support is to patients after CC radical resection, which is available to ameliorate the nutritional status, accelerate incision healing, and decline inflammation.

Analysis of post-operative efficacy and pharyngeal fistula healing in patients with laryngeal cancer treated with post-operative enteral nutrition support nursing combined with early oral feeding.

The present study aimed to analyze the effects of post-operative enteral nutrition support nursing combined with early oral feeding on post-operative efficacy and pharyngeal fistula (PF) healing in patients with laryngeal cancer (LC). A retrospective analysis of 133 patients with LC, who underwent laryngectomy between May 2014 and September 2016, was conducted. Of these patients, 61 patients (control group) were treated with enteral nutrition support nursing combined with nasogastric feeding, and 72 patients (observation group) were treated with enteral nutrition support nursing combined with early oral feeding. Levels of serum albumin (ALB), pre-albumin (PA), hemoglobin (Hb) and the lymphocyte count (LYM) were compared before and after surgery (7 and 14th post-operative days). The post-operative weight, upper arm muscle circumference (UAMC), triceps skinfold (TSF), post-operative infection, adverse reactions and PF healing were also measured. No differences were observed between the control and observation groups before surgery (all P>0.05). ALB, Hb, PA and LYM were significantly decreased in the control group on the 7 and 14th days post-operatively compared with those in the observation group (all P<0.05). Five patients in the control group presented with PF during treatment, and seven patients in the observation group suffered from PF after surgery. No difference in the average healing time of PF, number of patients with post-operative infection and adverse reactions were observed between the two groups (all P>0.05). The weight and UAMC in the observation group, 14 days post-operatively, were significantly higher than those before surgery in the same patients and in the control group (all P<0.05), whereas no difference in TSF (P>0.05) was observed. No differences in weight, UAMC and TSF were revealed in the control group before surgery and on the 14th day post-operatively (all P>0.05). Thus, post-operative enteral nutrition support nursing combined with early oral feeding resulted in significant improvement in the post-operative efficacy of patients with LC and had no effect on PF healing.

Long-term weight development after esophagectomy for cancer-comparison between open Ivor-Lewis and minimally invasive surgical approaches.

Esophagectomy is an extensive procedure with severe postoperative effects. It can be assumed that the greater the trauma, the longer the nutritional recovery. This retrospective observational single-center cohort study compared weight development after esophagectomy with open and minimally invasive techniques. Three groups were compared in this study, one representing the first 41 patients who underwent the minimally invasive McKeown esophagectomy (MIMK). The second group included the first 84 consecutive patients operated with the minimally invasive Ivor-Lewis esophagectomy (MIIL). The third group comprised 100 consecutive patients operated with open thoracoabdominal Ivor-Lewis esophagectomy (IL). Virtually all patients submitted to a minimally invasive esophagectomy (MIE) and the majority with an IL had a jejunal catheter inserted during operation for postoperative enteral feeding. All together 225 patients were included in this study. The mean weight loss during the first year was 13.1% (±4.1), 11.2% (±6.1), and 9.6% (±7.5) in the IL, MIIL, and MIMK group, respectively (P=0.85 and P=0.95, respectively). The median duration of postoperative enteral nutrition support varied substantially within the groups and was 23.5 days in the IL group (range: 0-2033 days), 54.5 days in those having an MIIL (range: 0-308 days; P≤0.001) and 57.0 days among patients in the MIMK group (range: 0-538 days; P≤0.022). There was no difference in the risk of losing at least 10% of the preoperative weight at 3 or 6 months postoperatively between the groups. However, in patients who suffered severe complications (Clavien-Dindo score≥IIIb) after MIIL, there was a nonsignificant trend toward a lower risk of a 10% or greater weight loss, 3 months postoperatively. In conclusion, the greater surgical trauma associated with the traditional open esophagectomy was not followed by more severe weight loss, or other signs of poorer nutritional recovery, when compared to minimal invasive surgical techniques.

Nursing progress of enteral nutrition support during postoperative intensive care unit in children with congenital heart diseases with low weight

With the development of cardiothoracic surgery, anesthesia, myocardial protection and in vitro technique, the management of congenital heart disease has gradually become younger and lower, and the nursing management of the postoperative system plays an important role. The purpose of this study was to analyze the causes of malnutrition in children with congenital heart disease < 6 kg, the significance of postoperative enteral nutrition support, nutritional assessment, oral feeding and tube feeding. Postoperative enteral nutrition support in children with congenital heart disease provides the most appropriate and accurate care, reduce the incidence of complications, optimize their quality of life and postoperative outcome. Key words: Malnutrition; Low weight; Congenital heart disease; Enteral nutrition

Effect of Glutamine on the Nucleic Acids Exchange during the Perioperative Period in Reconstructive Esophagus Surgery

Purpose: To assess the homeostasis of nucleic acids and nutritional status in the operation of one-stage esophagoplasty among patients diagnosed with achalasia of the esophagus or scar narrowing of esophagus after chemical burn. Methods: The study included 37 patients from 20 to 65 years old, male and female with achalasia of the esophagus or scar narrowing of the esophagus after chemical burn. All patients underwent one-stage esophagectomy wuth the following plastic. In the first group, patients received standard preoperative preparation (preoperative and postoperative enteral nutritional support by izokaloric mixture). Enteral mixture with increased concentration of glutamine (6 g/100 ml) was added to a standard enteral mixture in patients of the second group (15) counting glutamine as 0.5 g/kg/day (during three days before and two days after the surgery). DNA concentration of blood plasma and uric acid concentration in urine were counted for the assessment of nucleic acids metabolism. General clinical indicators were examined to assess the nutritional status (total serum protein and albumin, transferrin, the absolute number of blood lymphocytes). Results: The initial alimentary nutritional deficiency is exacerbated in the postoperative period because of development of the catabolism syndrome. We examined DNA concentration of serum and excretion of uric acid in the urine to assess the severity of nutritional deficiency, as one of the markers of nucleic acid homeostasis. Analyzing the results of the first group of patients, we saw a deep serum oligonucleotides deficiency in all phases of the perioperative period. Application of enteral mixture with glutamine in patients of the second group significantly improves exchange of nucleic acids and nutritional status. Conclusion: There were revealed the dependence of the homeostasis state of nucleic acids and nutritional status. Patients in the first group had had two postoperative complications (9.1%), in the second group there were no complications.

Postoperative Enteral Nutrition Improves Survival After Orthotopic Small Bowel Transplantation in Mice

BackgroundThe aim of this study was to assess the effect postoperative enteral nutrition support on the survival after orthotopic small bowel transplantation in mice. MethodsA model of orthotopic small bowel transplantation used C57BL/6 mice as both donors and recipients. ResultsWe demonstrated that postoperative ileus was the deciding complication after transplantation. Postoperative enteral nutritional support resolved this problem and significantly improved survival and growth rates after transplantation. ConclusionThese data suggest the importance of routine nutritional support after orthotopic small bowel transplantation in mice.

Clinical study and nursing care on early feeding enteral nutrition of postoperative esophageal cancer patients with nasointestinal tube

Objective To investigate the effect of early feeding enteral nutrition on the condition of nutrition,immunologic function and normalized nursing care of esophageal cancer patients.Methods Totals of 79 patients with esophageal cancer were randomly divided into the group of enteral nutrition (EN group,40 cases) and parenteral nutrition group (PN group,39 cases).All the subjects were treated the same conditional nutrition support and normalized nursing care after operation.Evacuating time and incidence of complication in two groups were observed and relative laboratory parameters were measured prior to surgery (preoperative) and on 3rd and 7th day after operation.Results Evacuating time of EN group was shorter than that of PN group significantly [(4.1 ± 2.2) vs (5.1 ± 2.0) days ; t =2.156,P =0.037],the serum level of prealbumin (in EN group on seven days postoperatively was improved than that in PN group [(20.97 ±6.14) vs (14.44 ± 7.43)mg/dl;t =2.533,P =0.015].The improvement of lymphocyte count in EN group was better than that of PN group [(1.67 ± 0.52) × 109 vs (1.40 ± 0.49) x 109/L],and the difference was statistically significant (t =2.243,P =0.028).The incidence of postoperative alimentary dysfunction in EN group lower than that in PN group (2.5％ vs 15.4％ ; x2 =4.059,P =0.044).Conclusions It is safety and convenience to carry early postoperative enteral nutrition support to patients with esophageal cancer after operation.The improvement of nutritional status and immunologic levels of early enteral nutrition was better than that of parenteral nutrition support. Key words: Esophygeal neoplasms; Parenteral nutrition; Nursing; Enteral nutrition

Nutritional management of patients undergoing major upper gastrointestinal surgery: A survey of current practice in Australia

AbstractAim: The aim of the present study was to survey current nutrition practice in Australian hospitals for the management of patients undergoing major upper gastrointestinal surgery, and to compare this with best practice, as it currently appears in the literature.Methods: A literature review was conducted to obtain current recommendations for the nutritional management of patients undergoing major upper gastrointestinal surgery. A survey was constructed to investigate whether these recommendations are being followed. Dietitians from tertiary‐referral public and private hospitals across Australia were contacted by telephone and invited to respond to the survey questions.Results: Forty‐two hospitals were contacted and 34 dietitians responded to the survey questions. Sixty‐three percent of dietitians reported minimal or no preoperative assessment of surgical patients, but 50% stated that they recommended immunonutrition when they did have preoperative contact, the majority following established dosage recommendations. Postoperative enteral nutrition support is not standard practice, being used routinely in only 30% of hospitals surveyed. Nutrition is usually recommenced on postoperative day 2 or 3. Post‐discharge follow up was provided by 35% of dietitians surveyed.Conclusion: Current recommendations in all aspects of nutrition are not being followed and there is great scope for improvement in managing patients undergoing major gastrointestinal surgery. Best practice guidelines and a shift in service provision to include better outpatient support for such a patient group is required.

Nightly Enteral Nutrition Support of Elderly Hip Fracture Patients: A Phase I Trial

Objective: This non-blinded randomized controlled trial was the first phase of a planned series of investigations designed to test the efficacy of aggressive post-operative enteral nutrition support to decrease the rate of post-operative complications or improve long-term outcomes in specifically defined subgroups of elderly patients who have sustained a hip fracture requiring surgery.Methods: Eighteen patients (17 males) were randomized to the treatment (eight male subjects) or control groups. The control group (mean age 76.5±6.1 years) received standard post-operative care. Subjects in the treatment group (mean age 74.5±2.1 years) received 125 cc/hour of nasoenteral tube feedings over 11 hours each night in addition to standard post-operative nutritional care.Results: Both the treatment and control groups had reduced volitional nutrient intakes for the first 7 post-operative days (3,966±2,238 vs. 4,263±2,916 kJ/day [948±535 vs. 1019±697 kcal/day], p=0.815), but the treatment subjects had a greater total nutrient intake (7,719±2,109 vs. 4,301±2,858 kJ/day [1845±504 vs. 1028±683 kcal], p=0.012). On average, treatment subjects were tube fed for 15.8±16.4 days. There was no difference between the groups (treatment vs. controls) in the rate of post-operative life-threatening complications (25 vs. 30%, p=1.00) or in-hospital mortality (0 vs. 30%, p=0.216). Mortality within 6 months subsequent to surgery was lower in the treatment group compared to the controls (0 vs. 50%, p=0.036).Discussion: We conclude that nightly enteral feedings are a safe and effective means of supplementing nutrient intake. The greatest impact of nutrition support may be to reduce mortality.

Postoperative Enteral Nutrition Support in Complicated Cardiac Surgery

Postoperative Enteral Nutrition Support in Complicated Cardiac Surgery