evidencia de la alimentación enteral precoz en la cirugía colorrectal evidence of early oral feeding in colorectal surgery
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ID: 194463
2007
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Abstract
Existe mucha variabilidad en el inicio de la alimentación enteral en los pacientes intervenidos de cirugía colorrectal, incluso en muchas ocasiones estos pacientes se mantienen con sonda nasogástrica en el postoperatorio, con el supuesto de prevenir complicaciones como la dehiscencia, evisceración o eventración. Realizamos una revisión de la evidencia clínica sobre el empleo de sonda nasogástrica y alimentación precoz consultando las bases del PubMed, Embase y la Cochrane. Encontramos evidencia Ia, Ib a partir de meta-análisis y estudios randomizados prospectivos donde se desaconseja el uso sistemático de la sonda de descompresión gástrica y se recomienda el inicio de una alimentación precoz en la cirugía colorrectal. La dieta absoluta no aporta ningún beneficio después de una cirugía gastrointestinal y con la sonda nasogástrica no disminuyen las complicaciones postoperatorias. Sin embargo, una cirugía menos invasiva y los avances en la anestesia y analgesia contribuyen a reducir el íleo postoperatorio.
There is much variability regarding time to start of enteral nutrition in patients undergoing colorectal surgery. In many instances such patients are postoperatively maintained with nasogastric intubation with the aim of preventing complications such as dehiscence, evisceration or eventration. We examine the clinical evidence regarding nasogastric tube placement and early feeding with reference to the PubMed, Embase, and Cochrane databases. Ia and Ib evidence was obtained from meta-analyses and prospective randomized studies, where the systematic use of a gastric decompression catheter is advised against and initiation of early feeding for colorectal surgery is recommended. Fasting does not provide any benefit after gastrointestinal surgery, and the use of nasogastric tubes does not decrease postoperative complications. However, less invasive surgery and new advances in anesthesia and analgesia are contributing to a reduction in postoperative ileus.
There is much variability regarding time to start of enteral nutrition in patients undergoing colorectal surgery. In many instances such patients are postoperatively maintained with nasogastric intubation with the aim of preventing complications such as dehiscence, evisceration or eventration. We examine the clinical evidence regarding nasogastric tube placement and early feeding with reference to the PubMed, Embase, and Cochrane databases. Ia and Ib evidence was obtained from meta-analyses and prospective randomized studies, where the systematic use of a gastric decompression catheter is advised against and initiation of early feeding for colorectal surgery is recommended. Fasting does not provide any benefit after gastrointestinal surgery, and the use of nasogastric tubes does not decrease postoperative complications. However, less invasive surgery and new advances in anesthesia and analgesia are contributing to a reduction in postoperative ileus.
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| Authors | ;F. Villalba Ferrer;M. Bruna Esteban;M. J. García Coret;J. García Romero;J. V. Roig Vila |
| Journal | chemistry of heterocyclic compounds |
| Year | 2007 |
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