BACKGROUND/AIMS: Enteral nutrition helps to prevent septic complications in patients with critical illness, but there are few reports on its use after hepatectomy. To evaluate its benefits, we studied the indications for it. METHODOLOGY: In a retrospective study we reviewed 67 hepatectomized patients, 19 with enteral nutrition after hepatectomy (EN group) and 48 without (TPN group). In the TPN group, the risk factors of postoperative infections were analyzed with discriminant analysis. Then we prospectively selected high-risk patients before surgery and started enteral nutrition soon after surgery. The incidences of postoperative infections were examined in the EN and TPN groups of high-risk patients. RESULTS: In high-risk patients selected using a new discriminant formula, the infection rate was decreased from 73.1% in the TPN group to 53.3% in the EN group (NS). However, in cases in which enteral nutrition was initiated within 4 days after surgery, the infection rate dropped to 30%, a significant decrease (P < 0.03). In this prospective study, the infection rate of high-risk patients was markedly decreased and the overall infection rate was decreased significantly, to 21.4% from 47.4% in the retrospective study (P < 0.02). CONCLUSIONS: We conclude that early enteral nutrition after hepatectomy is helpful for preventing septic complications, especially in patients at high risk of infection as evaluated with our new formula.
BACKGROUND/AIMS: Enteral nutrition helps to prevent septic complications in patients with critical illness, but there are few reports on its use after hepatectomy. To evaluate its benefits, we studied the indications for it. METHODOLOGY: In a retrospective study we reviewed 67 hepatectomized patients, 19 with enteral nutrition after hepatectomy (EN group) and 48 without (TPN group). In the TPN group, the risk factors of postoperative infections were analyzed with discriminant analysis. Then we prospectively selected high-risk patients before surgery and started enteral nutrition soon after surgery. The incidences of postoperative infections were examined in the EN and TPN groups of high-risk patients. RESULTS: In high-risk patients selected using a new discriminant formula, the infection rate was decreased from 73.1% in the TPN group to 53.3% in the EN group (NS). However, in cases in which enteral nutrition was initiated within 4 days after surgery, the infection rate dropped to 30%, a significant decrease (P < 0.03). In this prospective study, the infection rate of high-risk patients was markedly decreased and the overall infection rate was decreased significantly, to 21.4% from 47.4% in the retrospective study (P < 0.02). CONCLUSIONS: We conclude that early enteral nutrition after hepatectomy is helpful for preventing septic complications, especially in patients at high risk of infection as evaluated with our new formula.
Authors: Roberto Ciuni; Antonio Biondi; Giuseppe Grosso; Giuseppe Nunnari; Ettore Panascia; Lisa Randisi; Riccardo Volpes; Antonio Arcadipane; Francesco Basile; Bruno Gridelli; Salvatore Gruttadauria Journal: Updates Surg Date: 2011-11-09
Authors: Carlo Chiarla; Ivo Giovannini; Felice Giuliante; Francesco Ardito; Maria Vellone; Agostino Maria De Rose; Gennaro Nuzzo Journal: J Nutr Metab Date: 2012-03-29
Authors: A Weimann; Ch Ebener; S Holland-Cunz; K W Jauch; L Hausser; M Kemen; L Kraehenbuehl; E R Kuse; F Laengle Journal: Ger Med Sci Date: 2009-11-18