EARLY POSTOPERATIVE JEJUNAL FEEDING OF ELEMENTAL DIET IN GASTROINTESTINAL SURGERY

  • 1 January 1981
    • journal article
    • research article
    • Vol. 47  (9) , 393-403
Abstract
Gastric and colonic ileus after major abdominal operation precludes normal oral nutrition in the immediate postoperative period. Since small bowel motility and absorptive capacity are present immediately after operation, the small bowel may be used for feeding. The efficacy of early postoperative jejunal feeding of elemental diet was evaluated in 3 groups of patients. Adults (14) undergoing elective partial colectomy were randomized to receive jejunal feeding of elemental diet (ED) or isotonic i.v. infusions of dextrose (IV). Considering all avenues of nutrition for the first 10 postoperative days, 7 ED patients received a mean daily input of 2283 cal and 14.1 g of N compared to 800 cal and 3.4 g of N for the 7 IV controls (P < 0.005). The ED patients lost 2.4% of their body weight during the 1st postoperative month compared to a 6.1% weight loss for the IV controls (P < 0.005). The ED group required an i.v. catheter for 1.8 days, compared to 6.6 days for the IV group (P < 0.005). Twenty consecutive patients subjected to major upper gastrointestinal operations received a daily mean of 1468 cal and 9.7 g of N jejunally during the first 20 postoperative days. Mean weight loss at 2 and 4 wk postoperatively was 2.8 and 3.5% of preoperative weight. Ten patients received jejunal elemental diet for longer than 1 mo. because of postoperative complications or adjunctive therapy for cancer. Mean weight loss was 2.8%. Early postoperative jejunal feeding of elemental diet supplies more nutrients and results in less weight loss than does i.v. therapy with isotonic dextrose. Early postoperative feeding is of value in patients undergoing major operations on the upper gastrointestinal tract.