Medical Journal of the Islamic Republic Of Iran
مجله پزشکی جمهوری اسلامی ایران
Med J Islam Repub Iran
Medical Sciences
http://mjiri.iums.ac.ir
2
journal2
1016-1430
2251-6840
8
10.18869/mjiri
14
8888
13
en
jalali
1390
11
1
gregorian
2012
2
1
26
1
online
1
fulltext
en
Evaluation of supporting role of early enteral feeding via tube jejunostomy following resection of upper gastrointestinal tract
Surgery
Surgery
Original Research
Original Research
<p> <strong>Background:</strong> Today, early diagnosis of upper gastrointestinal (GI) tract malignancies and their surgical resection is becoming more feasible. One of the important side effects in upper GI tract malignancies is malnutrition which has direct relationship with postoperative complications. Nonetheless, there is no easy regimen of nutrition for these patients especially for the first week after operation. Accordingly we present a simple method for improving feeding such patients via tube jejunostomy. The aim of this study was to investigate the impact of early enteral feeding (EEF) on postoperative course after complete resection of upper gastrointestinal tract malignancy and reconstruction.</p><p> <strong>Methods:</strong> Between September 2005 to September 2008, 60 consecutive patients (22 female, 38 male) with upper GI tract malignancies who had undergone complete resection and reconstruction enrolled in this study. The patients randomly divided equally in two groups of control and EEF. Control group was treated with traditional management of nil by mouth and intravenous fluids for the first five postoperative days and then with liquids and enteral regular diet when tolerated. In EEF group the patients were fed by tube jejunostomy from 1<sup>st</sup> postoperative day and assessed for nutritional status before surgery and 5 days after surgery. Both groups were monitored on the basis of weight gain, clinical and paraclinical parameters and postoperative complications.</p><p> <strong>Results:</strong> Sixty patients were randomly divided to two equal groups. Surgical procedures were similar in two groups and no significant difference in demographic and basic nutritional status were found. On 5th postoperative day serum albumin was 4.2±0.4 g/dl in EEF and 3.6±0.3 g/dl in control group (p= 0.041). Also serum transferrin was 260.8±2.5 mg/dl and 208±1.8 mg/dl in EEF and control group respectively (p<0.001). Moreover, hospital stay was shorter in EEF group (7.7±3.1 vs. 14±2.5 days, p=0.009).There were four (13.3%) anasatomotic leakages in control group and one (3.3%) in EEF group (p=0.353). Also there was six (20%) wound infection in control group and three (10%) in EEF group (p=0.472).</p><p> <strong>Conclusion:</strong> The EEF by tube jejunostomy can be an effective method of feeding patients in postoperative days of resection of GI malignancies. Postoperative hospital stay would be shorter and the level of laboratory parameters especially serum transferrin is higher in EEF in comparison with control group. It also may reduce postoperative complications such as wound infection and enterocutaneous fistula.</p>
Nutrition, Postoperative Complications, Enteral feeding, Tube jejunostomy.
7
11
http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-291&slc_lang=en&sid=1
Ali
Ghafouri
alighafouri3@gmail.com
20031947532846007528
20031947532846007528
Yes
Department of Surgery, and Research Center for Improvement of Surgical Outcomes and Procedures, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Omran Abbas
Salehi
abbasomran2006@yahoo.com
20031947532846007529
20031947532846007529
No
Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Seyed Ali
Keshavarz
s_akeshavarz@yahoo.com
20031947532846007530
20031947532846007530
No
School of Hygiene, Tehran University of Medical Sciences, Tehran, Iran.
Saeed
Hosseini
saeedhmdphd@hotmail.com
20031947532846007531
20031947532846007531
No
Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Abolfazl
Shojaifard
shojaief@tums.ac.ir
20031947532846007532
20031947532846007532
No
Department of Surgery, and Research Center for Improvement of Surgical Outcomes and Procedures, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Zhamak
Khorgami
khorgami@gmail.com
20031947532846007533
20031947532846007533
No
Department of Surgery, and Research Center for Improvement of Surgical Outcomesand Procedures, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.