Clinical Aspects of Postoperative Enteral Feeding in the Surgical Patient
In this thesis clinical aspects of perioperative feeding in gastrointestinal surgery are discussed in several clinical studies. The main goal is to obtain insight in the influence of enteral feeding and enteral access route on recovery following gastrointestinal surgery. In two prospective randomized trials, early oral feeding was compared to a fixed regimen with regard to toleration, postoperative complications and duration of hospitalization. It could be concluded that early introduction of oral feeding is feasible, thus undermining the necessity of a postoperative fasting period, despite an incomplete postoperative recovery of gastrointestinal function. In two retrospective studies and one prospective trial diverse enteral access methods were evaluated in efficiency and complication rate in order to identify the safest enteral feeding route. Feeding jejunostomy was shown to be a potentially hazardous surgical procedure; a nasoduodenal tube is an effective means of enteral feeding as a jejunostomy. Laparoscopic feeding jejunostomy is an applicable method for patients who otherwise would need open surgery for placement of a jejunostomy catheter. In a retrospective study preoperative nutritional status is assessed in patients with esophageal malignancy. In this way the effect of nutritional status on postoperative infectious complications is established. We concluded that nutritional assessment with these specific parameters in patients with oesophageal malignancy is not suited for identifying a subgroup of patients in whom additional feeding would be beneficial. There is a need to develop nutritional assessment tools specific for patient category and surgical site.
|Keywords||complications, enteral feeding, nutritional assessment, surgery|
|Promotor||Jeekel, J. (Hans) , Tilanus, H.W. (Hugo)|
|Sponsor||Fresenius Kabi Nederland B.V. , Guerbet B.V. , Jeekel, Prof. Dr. J. , Nutricia Nederland B.V. , Nycomed Nederland B.V. , Tilanus, Prof. Dr. H.W.|
Han-Geurts, I.J.M.. (2006, March). Clinical Aspects of Postoperative Enteral Feeding in the Surgical Patient. Retrieved from http://hdl.handle.net/1765/7532