Updates in Surgery

, Volume 70, Issue 1, pp 105–112 | Cite as

Program of gastrointestinal rehabilitation and early postoperative enteral nutrition: a prospective study

  • Frank Daniel Martos-Benítez
  • Anarelys Gutiérrez-Noyola
  • Andrés Soto-García
  • Iraida González-Martínez
  • Ilionanys Betancourt-Plaza
Original Article

Abstract

Nutritional depletion is commonly observed in patients undergoing surgical treatment for a gastrointestinal malignancy. An appropriate nutritional intervention could be associated with improved postoperative outcomes. The study was aimed to determine the effect of a program of gastrointestinal rehabilitation and early postoperative enteral nutrition upon complications and clinical outcomes in patients who experienced gastrointestinal surgery for cancer. This is a prospective study (2013 January–2015 December) of 465 consecutive patients submitted to gastrointestinal surgery for cancer and admitted to an Oncological Intensive Care Unit. The program of gastrointestinal rehabilitation and early postoperative enteral nutrition consisted on: (1) general rules: pain relive, early mobilization, antibiotic prophylaxis, deep vein thrombosis prophylaxis and respiratory physiotherapy; and (2) gastrointestinal rules: gastric protection, control of postoperative nausea and vomiting, early nasogastric tube remove and early enteral nutrition. The most frequent surgical sites were colorectal (44.9%), gynecological with intestinal suturing (15.7%) and esophagus/stomach (11.0%). Emergency surgery was performed in 12.7% of patients. The program of intestinal rehabilitation and early postoperative enteral nutrition reduced major complications (19.2 vs. 10.2%; p = 0.030), respiratory complications (p = 0.040), delirium (p = 0.032), infectious complications (p = 0.047) and gastrointestinal complications (p < 0.001). Intensive care unit mortality (p = 0.018), length of intensive care unit stay (p < 0.001) and length of hospitalization (p < 0.001) were reduced as well. A program of gastrointestinal rehabilitation and early postoperative enteral nutrition is associated with reduced postoperative complications and improved clinical outcomes in patients undergoing gastrointestinal surgery for cancer.

Keywords

Gastrointestinal cancer Postoperative nutrition Enhanced recovery after surgery Postoperative complication Outcome 

Notes

Acknowledgements

The authors would like to thank Lucia Chang-Navarro for his help with the translation into English.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

This article does not involve any studies with animals.

Informed consent

This is a prospective study, and was therefore conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained from all patients.

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Copyright information

© Italian Society of Surgery (SIC) 2018

Authors and Affiliations

  1. 1.Intensive Care Unit 8BHermanos Ameijeiras HospitalHavanaCuba
  2. 2.Oncological Intensive Care UnitInstitute of Oncology and RadiobiologyHavanaCuba
  3. 3.Miguel Enríquez Teaching HospitalHavanaCuba

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