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. 2020 Aug;272(2):377-383.
doi: 10.1097/SLA.0000000000003128.

Early Enteral Nutrition Following Gastrointestinal Surgery in Children: A Systematic Review of the Literature

Sarah Braungart  1 , Sotirios Siminas
Affiliations

Early Enteral Nutrition Following Gastrointestinal Surgery in Children: A Systematic Review of the Literature

Sarah Braungart et al. Ann Surg. 2020 Aug.

Abstract

Objective: To investigate the safety and effectiveness of early enteral feeding versus traditional enteral feeding after gastrointestinal (GI) anastomosis in children in the pediatric literature.

Summary of background data: Prolonged postoperative fasting has been the traditional model of care following pediatric GI surgery. In contrast, early feeding has become well established in the adult population, where meta-analyses have shown early introduction of enteral feeds to be beneficial to hospital stay and patient outcomes.

Methods: Comprehensive literature searches of the English literature search (PubMed, Ovid, Embase databases) from inception to present according to the PRISMA guidelines. Included studies were assessed according to the MINORS criteria. Outcomes for time to first feed and full feeds, and discharge, and risk of major complications were synthesized.

Results: Ten studies comprising 451 patients were included in the analysis. All studies aimed at investigating the safety of early feeding in pediatric GI surgery, with or without a fast-track program. Only 4 studies compared the study group to a control group in which patients were fed in a traditional way (traditional feeding).Most studies defined early feeding as feeds commenced ≤24 hours postoperatively (range 2-72 hours). Mean time to first feed was significantly lower in the early feeding group, but not significantly lower for the mean time to full feeds and mean hospital stay. Bowel obstruction and anastomotic breakdown were classed as major complications. There was no significant difference in their occurrence in both groups.

Conclusions: Although the studies identified are few and heterogeneous, they demonstrate that there is no clear advantage of keeping children "nil by mouth" and no clear disadvantage of providing early enteral nutrition following elective gastrointestinal surgery. Larger randomized controlled trials are required to assess the true impact on postoperative complications, health care associated costs, and to investigate patient-reported outcome measures.

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References

    1. Mattei R, Rombeaud JL. Review of the pathophysiology and management of postoperative ileus. World J Surg 2006; 30:1382–1391.
    1. Mangesi L, Hofmeyr GJ. Early compared with delayed oral fluids and food after caesarean section. Cochrane Database Syst Rev 2002; CD003516.
    1. Andersen HK, Lewis SJ, Thomas S. Early enteral nutrition within 24 h of colorectal surgery versus later commencement of feeding for postoperative complications. Cochrane Database Syst Rev 2006; CD004080.
    1. Lewis SJ, Andersen HK, Thomas S. Early enteral nutrition within 24 h of intestinal surgery versus later commencement of feeding: a 17 systematic review and meta-analysis. J Gastrointest Surg 2009; 13:569–575.
    1. Osland E, Yunus RM, Khan S, et al. Early versus traditional postoperative feeding in patients undergoing resectional gastrointestinal surgery: a meta-analysis. JPEN J Parenter Enteral Nutr 2011; 35:473–487.

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