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The effect of early oral postoperative carbohydrates feeding on postoperative outcome

تأثير التغذية الفموية الباكرة بالمحاليل السكرية بعد العمل الجراحي على حدوث المضاعفات التالية للعمل الجراحي

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 Publication date 2017
and research's language is العربية
 Created by Shamra Editor




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Introduction: Ileus commonly occurs after abdominal surgery, and is associated with complications and increased length of hospital stay. Post-operative ileus (POI) is an important reason for remaining patients not permit oral (NPO) in post-operative period. The tradition was that when patients passed flatus, they were ready to consume a liquid diet, and then a solid food diet was gradually introduced. This approach was taken to avoid aspiration, gastric and intestinal distension, and anastomotic dehiscence. Although studies demonstrated that the conventional strict feeding regimens were not necessary, many surgeons still hesitated to allow early oral feeding. There has been concern that early oral intake would result in vomiting and severe paralytic ileus with subsequent aspiration pneumonia, wound dehiscence and anastomotic leakage. This belief has become surgical dogma, unsupported by scientific evidence. Aim: to investigates the effect of early oral postoperative carbohydrates feeding on postoperative outcome. Material and methods: forty abdominal surgery patients were randomly assigned to early oral postoperative feeding group (20) or traditional feeding group (20). In the early feeding group (study group), patients were initially started on clear fluid only 16 h after surgery and progressed to liquids (after 24 h) and then soft and regular diet in next day (after 48 h). In the post-operative period, the patients were visited each 12 h and clinical signs and symptoms such as, time of passed flatus and moved their bowels, nausea and vomiting, and the length hospital stay were assessed. Conclusions: This study showed that early oral postoperative carbohydrates feeding group passed flatus and moved their bowels much sooner than the control group thus reducing the duration of POI and hospital stay, but there is no increase in occurrence of of nausea and vomiting between tow groups.


Artificial intelligence review:
Research summary
تتناول هذه الدراسة تأثير التغذية الفموية الباكرة بالمحاليل السكرية بعد العمليات الجراحية البطنية على حدوث المضاعفات التالية للعمل الجراحي. يعاني المرضى عادةً من الشلل المعوي بعد العمليات الجراحية البطنية، مما يؤدي إلى بقاء المريض في المستشفى لفترة أطول. الهدف من الدراسة هو تحديد تأثير التغذية الفموية الباكرة على زمن عودة الحركات الحوية، مرور الغازات، حدوث الغثيان والقيء، ومدة بقاء المريض في المستشفى. تم تقسيم 40 مريضاً إلى مجموعتين: مجموعة تجريبية تلقت التغذية الفموية الباكرة بالمحاليل السكرية، ومجموعة ضابطة اتبعت الروتين التقليدي للمستشفى. أظهرت النتائج أن التغذية الفموية الباكرة ساعدت في تسريع عودة الحركات الحوية ومرور الغازات، مما قلل من مدة بقاء المرضى في المستشفى، دون زيادة ملحوظة في حدوث الغثيان والقيء بين المجموعتين.
Critical review
تعتبر الدراسة خطوة مهمة نحو تحسين الرعاية بعد العمليات الجراحية البطنية، إلا أن هناك بعض النقاط التي يمكن مناقشتها. أولاً، حجم العينة صغير نسبياً (40 مريضاً فقط)، مما قد يؤثر على تعميم النتائج. ثانياً، لم تتناول الدراسة تأثير التغذية الفموية الباكرة على أنواع أخرى من العمليات الجراحية مثل العمليات القلبية أو العظمية، مما يحد من نطاق تطبيق النتائج. ثالثاً، كان من الأفضل تضمين متغيرات إضافية مثل مستوى الألم واستخدام المسكنات، حيث يمكن أن تؤثر هذه العوامل على نتائج الدراسة. أخيراً، على الرغم من أن النتائج مشجعة، إلا أن هناك حاجة لمزيد من الدراسات لتأكيد هذه النتائج وتحديد أفضل الممارسات السريرية.
Questions related to the research
  1. ما هو الهدف الرئيسي من هذه الدراسة؟

    الهدف الرئيسي هو تحديد تأثير التغذية الفموية الباكرة بالمحاليل السكرية بعد العمليات الجراحية البطنية على حدوث المضاعفات التالية للعمل الجراحي.

  2. ما هي النتائج الرئيسية التي توصلت إليها الدراسة؟

    أظهرت الدراسة أن التغذية الفموية الباكرة ساعدت في تسريع عودة الحركات الحوية ومرور الغازات، مما قلل من مدة بقاء المرضى في المستشفى، دون زيادة ملحوظة في حدوث الغثيان والقيء بين المجموعتين.

  3. ما هي العينة المستخدمة في الدراسة وكيف تم تقسيمها؟

    تم استخدام عينة من 40 مريضاً خضعوا لعمليات جراحية بطنية، وتم تقسيمهم عشوائياً إلى مجموعتين: مجموعة تجريبية تلقت التغذية الفموية الباكرة بالمحاليل السكرية، ومجموعة ضابطة اتبعت الروتين التقليدي للمستشفى.

  4. ما هي التوصيات التي قدمتها الدراسة بناءً على النتائج؟

    أوصت الدراسة باعتماد سياسة التغذية الفموية الباكرة بالمحاليل السكرية للمرضى الذين يخضعون لعمليات جراحية بطنية، وذلك لتسريع عودة الحركات الحوية وتقليل مدة بقاء المرضى في المستشفى.


References used
LEWIS SJ, MATTHIAS EGGER, PAUL A SYLVESTER, STEVEN THOMAS. Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ 2001;323:773-6
ZHUANG CL, YE XZ, ZHANG CJ, DONG QT, CHEN BC, YU Z. Early versus traditional postoperative oral feeding in patients undergoing elective colorectal surgery: a meta-analysis of randomized clinical trials. Dig Surg. 2013;30(3):225-32
NIHON GEKA GAKKAI ZASSHI. A new concept of the postoperative oral feeding regimen after upper gastrointestinal surgery in the laparoscopic era. 2010 Jan;111(1):13-7
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