OUTCOME OF EARLY INITIATION OF POST-SURGERY FEEDING AFTER COLOSTOMY REVERSAL IN CHILDREN
Keywords:
Colorectal surgery, complications, outcome, oral feedingAbstract
Background: Children undergoing colostomy reversal surgery often face uncertainties regarding the optimal timing for reintroducing feeding postoperatively. Early initiation of post-surgery feeding is of interest due to its potential to hasten recovery and reduce hospital stay. The impact of early feeding initiation is unclear. Objective of this study was to find out the outcome in terms of hospital stay and post-surgery complications of early initiation of post-surgery feeding after elective colostomy reversal in children. Methods: From 6 Jun 2022 to 10 Oct 2023, a non-randomized controlled trial was conducted at Bahawalpur, analyzing 93 children under 15 years with status colostomy following elective reversal. Patients were allocated to Group-A (traditional oral feeding) or Group-B (early oral feeding) at the surgeon’s discretion, with outcomes including post-surgery hospital stay duration and complications. Results: Out of a total of 93 patients, 49 (52.7%) were boys and 44 (47.3%) girls. Overall, mean age was 4.86±3.27 years. Anastomotic shock was noted among 6 (6.5%) patients while 9 (9.7%) patients had superficial surgical site infection. None of the patients needed repeat surgery for any post-surgery complications. No significant difference in terms of anastomotic leak (p=0.3983), and superficial surgical site infection (p=0.4980) were observed. Significantly shorter duration of post-surgery hospital stay was recorded among patients of Group-B when to compared to Groups-A (6.49±1.14 vs 8.90±1.27, p<0.0001). Conclusion: Early initiation of enteral feeding post elective colostomy reversal in children resulted in significantly reduced duration of post-surgery hospital stay.
Pak J Physiol 2024;20(1):30-2
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Davila?Perez R, Bracho?Blanchet E, Tovilla?Mercado JM, Hernandez?Plata JA, Reyes?Lopez A, Nieto?Zermeño J. Unnecessary gastric decompression in distal elective bowel anastomoses in children: a randomized study. World J Surg 2010;34:947–53.
Paul SK, Biswas I, Howlader S, Paul SK, Khan AR. Early enteral feeding versus traditional feeding after colostomy closure in paediatric patients: A comparative study of postoperative outcome. Faridpur Med Coll J 2015;10:29–32.
Stewart BT, Woods RJ, Collopy BT, Fink RJ, Mackay JR, Keck JO. Early feeding after elective open colorectal resections: A prospective randomized trial. Aust N Z J Surg 1998;68(2):125–8.
Han?Geurts IJ, Hop WC, Kok NF, Lim A, Brouwer KJ, Jeekel J. Randomized clinical trial of the impact of early enteral feeding on postoperative ileus and recovery. Br J Surg 2007;94:555–61.
Sangkhathat S, Patrapinyokul S, Tadyathikom K. Early enteral feeding after closure of colostomy in pediatric patients. J Pediatr Surg 2003;38:1516–9.
Weledji EP. Perspectives on paralytic ileus. Acute Med Surg 2020;7(1):e573.
Shakya P, Bhuvan C. A myth that early feeding causes bowel anastomotic leakage: is it true? Int Surg J 2016;3(1):81–3.
Amanollahi O, Azizi B. The comparative study of the outcomes of early and late oral feeding in intestinal anastomosis surgeries in children. Afr J Paediatr Surg 2013;10(2):74–7.
Dag A, Colak T, Turkmenoglu O, Gundogdu R, Aydin S. A randomized controlled trial evaluating early versus traditional oral feeding after colorectal surgery. Clinics (Sao Paulo) 2011;66:2001–5.
Lewis SJ, Egger M, Sylvester PA, Thomas S. Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: Systematic review and meta?analysis of controlled trials. BMJ 2001;323:773–6.
Shang Q, Geng Q, Zhang X, Xu H, Guo C. The impact of early enteral nutrition on pediatric patients undergoing gastrointestinal anastomosis a propensity score matching analysis. Medicine (Baltimore) 2018;97(9):e0045.
Alaku? H, Göksu M, Erten S. Early enteral nutrition with L-glutamine improves anastomotic healing in rats administered hyperthermic intraperitoneal chemotherapy with cisplatin and 5-FU. J Surg Med 2021;5(9):848–52.
Gomes SL, Santos PM, Costa Pereira J, Martins SF. Ileocolic anastomosis dehiscence in colorectal cancer surgery. Gastrointest Disord 2023;5(2):273–86.
Wischmeyer PE. Nutrition therapy in sepsis. Crit Care Clin 2018;34(1):107–25.
Ghosh A, Biswas SK, Basu KS, Biswas SK. Early feeding after colorectal surgery in children: is it safe? Indian Assoc Pediatr Surg 2020;25(5):291–6.
Lu C, Sun X, Geng Q, Tang W. Early oral feeding following intestinal anastomosis surgery in infants: a multicenter real world study. Front Nutr 2023;10:1185876.
Nematihonar B, Salimi S, Noorian V, Samsami M. Early versus delayed (traditional) postoperative oral feeding in patients undergoing colorectal anastomosis. Adv Biomed Res 2018;7:30.
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