Early Oral Feeding Versus Traditional Postoperative Care in Emergency Abdominal Surgery

Hospital General de Agudos "Dr. Cosme Argerich"336 enrolled

Overview

The traditional postoperative care after abdominal surgery included the need of nasogastric tube, fasting until resumed bowel function and progressive reinstitution of oral intake from liquid to solid diet. Recent studies have shown no benefits of this traditional management over early oral feeding. Nevertheless, the researches in emergency surgery are scarce.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

336

Conditions

Postoperative Care

Interventions

Early oral feedingOTHER

Within 6-24 hours after surgery the nasogastric tube will be removed and liquids and soft diet "at will" indicated.

Traditional CareOTHER

They will have nasogastric tube and restriction of oral intake until the first sign of restoration of intestinal transit (first flatus or stool, whichever comes first). Since then withdrew nasogastric tube and liquid diet starts within 24 hours, then continues with soft diet.

Eligibility

Sex: ALLMin age: 14 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients over 14 years after abdominal emergency surgery. Exclusion Criteria: * Lack of consensus of the patient * Concurrent extra-abdominal surgery * Short bowel or other clear indication of parenteral nutrition * Inability to feed orally (eg, decreased level of consciousness) * Interventional procedure * Esophageal surgery * Reoperations * Pancreatitis

Locations (1)

Argerich Hospital

Buenos Aires, Buenos Aires, Argentina

Outcomes

Primary Outcomes

Postoperative Complications

The rate of postoperative complications according with Clavien-Dindo classification, defined as "any deviation from the normal postoperative course".

Time frame: At 30 days or at discharge

Secondary Outcomes

Gastrointestinal leaks

"the leak of luminal contents from a surgical join between two hollow viscera or from surgical repair of continuity solution. The luminal contents may emerge either through the wound or at the drain site, or they may collect near the anastomosis or rapair, causing fever, abscess, septicaemia, metabolic disturbance and/or multiple-organ failure. The escape of luminal contents intoan adjacent localised area, detected by imaging, in the absence of clinical symptoms and signs should be recorded as a subclinical leak"

Time frame: At 30 days or at discharge

Time to resume bowel functions

Time from surgery to the first flatus or deposition, whatever occurs first

Time frame: At 30 days or at discharge

Oral diet intolerance

The appearance of vomits or abdominal pain after diet

Time frame: At 30 days or at discharge

Postoperative hospital stay

Time frame: At 90 days

Data from ClinicalTrials.gov

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