EARLY ENTERAL FEEDING FOLLOWING SMALL GUT ANASTOMOSIS; AN INSTITUTION BASED PROSPECTIVE STUDY. ?nce barsak anastomozlar?n? takiben erken d?nem enteral beslenme; Kurumsal bir prospektif ?al??ma.

摘要

Gut anastomosis is one of the frequently performed surgeries in both emergency and elective setup. As a conventional practice following gut anastomosis, patients are kept "nil by mouth" till bowel sounds return. Recently great emphasis has been paid on early enteral feeding within 6 to 24 hrs after operation. The aim of our study was to see whether early enteral feeding within 24 hrs of small gut anastomosis is tolerable and beneficial to the patient. Feasibility, safety and efficacy of early enteral feeding after small gut anastomosis were assessed in terms of morbidities like? incidence of vomiting, rate of anastomotic leak, infective complication and length of post-operative hospital stays in days. Among our 51 patients 15 (29.41%) were operated in emergency and 36(70.59%) by elective means. All the 51 patients were given early enteral feeding with clear water 18 hours after gut anastomosis. Out of 51 patients only 5 (9.80%) developed postoperative nausea and vomiting. The mean time of appearance of IPS was 1.19 days (SD 0.49). Mean time of passage of flatus is 1.84 days (SD 0.53). Three patients (5.88%) out of 51 developed clinical evidence of anastomotic leakage. The mean duration of hospital stay was 8.84 days (SD2.9).? Two (3.92%) out of 51 patients of gut anastomosis die. In conclusion, the conventional wisdom of withholding enteral feeds for prolonged periods to coincide with the appearance of peristaltic sounds might not stand the test of time and early feeding is beneficial to the patients.? ? ? ?ZET Barsak anastomozu acil ve elektif cerrahide s?k yap?lan i?lemlerden birisidir. Genel cerrahi prati?inde, ameliyat sonras?nda hastalara barsak sesleri duyuluncaya kadar a??zdan g?da verilmez. Son zamanlarda ameliyat sonras?ndaki 6-24 saat i?erisinde yap?lacak erken enteral beslenmenin ?nemi vurgulanmaktad?r. Bu ?al??mada barsak anastomozlu hastalarda ameliyat sonras? 6-24 saatlik d?nemde yap?lan erken enteral beslenmenin sonu?lar? g?zlemlenmi?tir. Barsak anastomozu sonras?nda yap?lan erken d?nem enteral beslenmenin uygulanabilirli?i, güvenilirli?i ve etkinli?i bak?m?ndan de?erlendirilmek amac?yla ameliyat sonras?nda g?rülen bulant?-kusma, anastomoz a??lma oran?, enfeksiyon durumu ve hastanede kalma gibi morbidityi tan?mlayan parametrelere bak?ld?. 51 hastal?k serimizde, 15 (%29.14) vaka acil ?artlarda 36 (%70.59) vaka ise elektif ?artlarda? ameliyat edildi. Hastalar?n hepsine ameliyattan 18 saat sonra su verildi. Yaln?z 5 (%9.8) hastada bulant?-kusma saptand?. Barsak sesleri 1.19 günde (SD 0.49), gaz ??karma 1.84 günde (SD 0.53) ba?lad?. ü? hastada (%5.88) anastomoz a??lmas? saptand?. Hastanede kalma süresi ortalama 8.84 gündü (SD 2.9). Hastalardan ikisi (%3.92) ?ldü. Sonu? olarak; geleneksel olarak enteral s?v? verilmeyen hastalarla verilenler aras?nda komplikasyonlar bak?m?ndan anlaml? bir fark olmad???, erken d?nemde yap?lacak enteral beslenmenin faydal? oldu?u s?ylenebilir.