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Clinical feasibility and nutritional effects of early oral feeding after pancreaticoduodenectomy.

Hwang SE, Jung MJ, Cho BH, Yu HC - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: The aim of this study was to evaluate the clinical feasibility, safety, and nutritional effects of EOF after PD.In the clinically acute phase from postoperative day 1 to day 5, the mean daily calorie intake (847.0 kcal vs. 745.6 kcal; p=0.04) and mean daily protein intake (42.2 g vs. 31.9 g; p=0.00) in the EOF group were significantly higher than that in the TOF group.Postoperative EOF is a clinically safe, feasible, and effective method of nutritional support after PD.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Daejeon Sun Hospital, Daejeon, Korea.

ABSTRACT

Backgrounds/aims: Pancreaticoduodenctomy (PD) is associated with high rates of postoperative morbidity and mortality. Although many studies have shown that early postoperative enteral nutrition improves postoperative outcomes, limited clinical information is available on postoperative early oral feeding (EOF) after PD. The aim of this study was to evaluate the clinical feasibility, safety, and nutritional effects of EOF after PD.

Methods: Clinical outcomes were investigated in 131 patients who underwent PD between 2003 and 2013, including 81 whose oral feeding was commenced within 48 hours (EOF group) and 50 whose oral feeding was commenced after resumption of bowel movements (traditional oral feeding [TOF] group). Postoperative complications, energy intake, and length of stay (LOS) were reviewed.

Results: Demographic factors were similar in the two groups. The EOF group had a significantly shorter LOS (25.9±8.5 days vs. 32.3±16.3 days; p=0.01) than the TOF group. The rates of anastomotic leak (1.2% vs. 16%, p=0.00) and reoperation (3.7% vs. 20%, p=0.01) were significantly lower in the EOF group. In the clinically acute phase from postoperative day 1 to day 5, the mean daily calorie intake (847.0 kcal vs. 745.6 kcal; p=0.04) and mean daily protein intake (42.2 g vs. 31.9 g; p=0.00) in the EOF group were significantly higher than that in the TOF group.

Conclusions: Postoperative EOF is a clinically safe, feasible, and effective method of nutritional support after PD.

No MeSH data available.


Related in: MedlinePlus

Mean daily total calorie and protein intake in the EOF and TOF groups. Patients in the EOF and TOF groups received 30% and 17%, respectively, of their calorie goals through the enteral route and 41% and 51%, respectively, through the parenteral route from POD 1 to 14. Patients in the EOF and TOF groups received 23% and 14%, respectively, of their protein goals through the enteral route and 41% and 52%, respectively, through the parenteral route. The mean daily calorie (1018 kcal vs. 972 kcal; p=0.30) and protein (44.3 g vs. 44.4 g; p=0.98) intake from POD 1 to 14 were similar in the EOF and TOF groups. From POD 1 to 5, however, the mean daily calorie (847.0 kcal vs. 745.6 kcal; p=0.04) and protein (42.2 g vs. 31.9 g; p=0.00) intake was significantly higher in the EOF than in the TOF group, as was the mean percentage of total daily calorie (60.1% vs. 51.3%; p=0.02) and protein (62.1% vs. 45.9%; p=0.00) intake. Arrows indicate a percent of requirement of energy and protein from postoperative day 1 to 5. EOF: early oral feeding; TOF: traditional oral feeding; POD: postoperative day.
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Figure 1: Mean daily total calorie and protein intake in the EOF and TOF groups. Patients in the EOF and TOF groups received 30% and 17%, respectively, of their calorie goals through the enteral route and 41% and 51%, respectively, through the parenteral route from POD 1 to 14. Patients in the EOF and TOF groups received 23% and 14%, respectively, of their protein goals through the enteral route and 41% and 52%, respectively, through the parenteral route. The mean daily calorie (1018 kcal vs. 972 kcal; p=0.30) and protein (44.3 g vs. 44.4 g; p=0.98) intake from POD 1 to 14 were similar in the EOF and TOF groups. From POD 1 to 5, however, the mean daily calorie (847.0 kcal vs. 745.6 kcal; p=0.04) and protein (42.2 g vs. 31.9 g; p=0.00) intake was significantly higher in the EOF than in the TOF group, as was the mean percentage of total daily calorie (60.1% vs. 51.3%; p=0.02) and protein (62.1% vs. 45.9%; p=0.00) intake. Arrows indicate a percent of requirement of energy and protein from postoperative day 1 to 5. EOF: early oral feeding; TOF: traditional oral feeding; POD: postoperative day.

Mentions: From postoperative days (POD) 1 to 14, patients in the EOF and TOF groups received 30% and 17%, respectively, of their energy goals through the enteral route and 41% and 51%, respectively, through the parenteral route. In addition, patients in the EOF and TOF groups received 23% and 14%, respectively, of their protein goals through the enteral route and 41% and 52%, respectively, through the parenteral route. The mean daily calorie intake (1018 vs. 972 kcal; p=0.30) and protein intake (44.3 vs. 44.4 g; p=0.98) from POD 1 to 14 were similar in the two groups. In the clinically acute phase, from POD 1 to 5, however, the mean daily calorie (847.0 kcal vs. 745.6 kcal; p=0.04) and protein (42.2 g vs. 31.9 g; p=0.00) intake were significantly greater in the EOF than in the TOF group. From POD 1 to 5, patients in these two groups also differed significantly in their mean percentages of total daily calorie intake (60.1% vs. 51.3%; p=0.02) and protein intake (62.1% vs. 45.9%; p=0.00) (Fig. 1).


Clinical feasibility and nutritional effects of early oral feeding after pancreaticoduodenectomy.

Hwang SE, Jung MJ, Cho BH, Yu HC - Korean J Hepatobiliary Pancreat Surg (2014)

Mean daily total calorie and protein intake in the EOF and TOF groups. Patients in the EOF and TOF groups received 30% and 17%, respectively, of their calorie goals through the enteral route and 41% and 51%, respectively, through the parenteral route from POD 1 to 14. Patients in the EOF and TOF groups received 23% and 14%, respectively, of their protein goals through the enteral route and 41% and 52%, respectively, through the parenteral route. The mean daily calorie (1018 kcal vs. 972 kcal; p=0.30) and protein (44.3 g vs. 44.4 g; p=0.98) intake from POD 1 to 14 were similar in the EOF and TOF groups. From POD 1 to 5, however, the mean daily calorie (847.0 kcal vs. 745.6 kcal; p=0.04) and protein (42.2 g vs. 31.9 g; p=0.00) intake was significantly higher in the EOF than in the TOF group, as was the mean percentage of total daily calorie (60.1% vs. 51.3%; p=0.02) and protein (62.1% vs. 45.9%; p=0.00) intake. Arrows indicate a percent of requirement of energy and protein from postoperative day 1 to 5. EOF: early oral feeding; TOF: traditional oral feeding; POD: postoperative day.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4492322&req=5

Figure 1: Mean daily total calorie and protein intake in the EOF and TOF groups. Patients in the EOF and TOF groups received 30% and 17%, respectively, of their calorie goals through the enteral route and 41% and 51%, respectively, through the parenteral route from POD 1 to 14. Patients in the EOF and TOF groups received 23% and 14%, respectively, of their protein goals through the enteral route and 41% and 52%, respectively, through the parenteral route. The mean daily calorie (1018 kcal vs. 972 kcal; p=0.30) and protein (44.3 g vs. 44.4 g; p=0.98) intake from POD 1 to 14 were similar in the EOF and TOF groups. From POD 1 to 5, however, the mean daily calorie (847.0 kcal vs. 745.6 kcal; p=0.04) and protein (42.2 g vs. 31.9 g; p=0.00) intake was significantly higher in the EOF than in the TOF group, as was the mean percentage of total daily calorie (60.1% vs. 51.3%; p=0.02) and protein (62.1% vs. 45.9%; p=0.00) intake. Arrows indicate a percent of requirement of energy and protein from postoperative day 1 to 5. EOF: early oral feeding; TOF: traditional oral feeding; POD: postoperative day.
Mentions: From postoperative days (POD) 1 to 14, patients in the EOF and TOF groups received 30% and 17%, respectively, of their energy goals through the enteral route and 41% and 51%, respectively, through the parenteral route. In addition, patients in the EOF and TOF groups received 23% and 14%, respectively, of their protein goals through the enteral route and 41% and 52%, respectively, through the parenteral route. The mean daily calorie intake (1018 vs. 972 kcal; p=0.30) and protein intake (44.3 vs. 44.4 g; p=0.98) from POD 1 to 14 were similar in the two groups. In the clinically acute phase, from POD 1 to 5, however, the mean daily calorie (847.0 kcal vs. 745.6 kcal; p=0.04) and protein (42.2 g vs. 31.9 g; p=0.00) intake were significantly greater in the EOF than in the TOF group. From POD 1 to 5, patients in these two groups also differed significantly in their mean percentages of total daily calorie intake (60.1% vs. 51.3%; p=0.02) and protein intake (62.1% vs. 45.9%; p=0.00) (Fig. 1).

Bottom Line: The aim of this study was to evaluate the clinical feasibility, safety, and nutritional effects of EOF after PD.In the clinically acute phase from postoperative day 1 to day 5, the mean daily calorie intake (847.0 kcal vs. 745.6 kcal; p=0.04) and mean daily protein intake (42.2 g vs. 31.9 g; p=0.00) in the EOF group were significantly higher than that in the TOF group.Postoperative EOF is a clinically safe, feasible, and effective method of nutritional support after PD.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Daejeon Sun Hospital, Daejeon, Korea.

ABSTRACT

Backgrounds/aims: Pancreaticoduodenctomy (PD) is associated with high rates of postoperative morbidity and mortality. Although many studies have shown that early postoperative enteral nutrition improves postoperative outcomes, limited clinical information is available on postoperative early oral feeding (EOF) after PD. The aim of this study was to evaluate the clinical feasibility, safety, and nutritional effects of EOF after PD.

Methods: Clinical outcomes were investigated in 131 patients who underwent PD between 2003 and 2013, including 81 whose oral feeding was commenced within 48 hours (EOF group) and 50 whose oral feeding was commenced after resumption of bowel movements (traditional oral feeding [TOF] group). Postoperative complications, energy intake, and length of stay (LOS) were reviewed.

Results: Demographic factors were similar in the two groups. The EOF group had a significantly shorter LOS (25.9±8.5 days vs. 32.3±16.3 days; p=0.01) than the TOF group. The rates of anastomotic leak (1.2% vs. 16%, p=0.00) and reoperation (3.7% vs. 20%, p=0.01) were significantly lower in the EOF group. In the clinically acute phase from postoperative day 1 to day 5, the mean daily calorie intake (847.0 kcal vs. 745.6 kcal; p=0.04) and mean daily protein intake (42.2 g vs. 31.9 g; p=0.00) in the EOF group were significantly higher than that in the TOF group.

Conclusions: Postoperative EOF is a clinically safe, feasible, and effective method of nutritional support after PD.

No MeSH data available.


Related in: MedlinePlus