[Immediate post-operative enteral nutrition]

Area of Science:

• Gastroenterology
• Surgical Nutrition
• Oncology

Background:

• Upper digestive tract cancer patients often experience malnutrition, increasing risks of immunodepression and postoperative complications.
• Effective nutritional support is crucial for recovery after extensive upper digestive tract surgeries.

Purpose of the Study:

• To evaluate the rationale, feasibility, and effectiveness of immediate postoperative enteral nutrition (NEPI) in patients undergoing major upper digestive tract surgery.
• To assess the impact of NEPI on nutritional status, tolerance, and postoperative outcomes.

Main Methods:

• A study involving 46 patients who underwent total gastrectomy, oesophageal resection, or duodenocephalopancreasectomy.
• Initiation of NEPI on postoperative day 0 using a polymeric diet, with a target calorie intake of 25 Kcal/Kg/day by postoperative day 4.
• Monitoring of nutritional indices, tolerance, weight loss, septic complications, and mortality.

Main Results:

• NEPI successfully delivered 24 Kcal/kg/day from postoperative days 4-10, with good tolerance in 89% of patients.
• Mean postoperative weight loss was 3.7%, septic complications occurred in 27% of patients, and mortality was nil.
• NEPI preserved postoperative nutritional status, showing no significant changes in nutritional indices compared to baseline at 10-14 days.

Conclusions:

• Immediate postoperative enteral nutrition (NEPI) is feasible and well-tolerated following extensive upper digestive tract surgery.
• NEPI provides adequate nutritional support, helps maintain nutritional status, and may contribute to better patient outcomes.
• Starting NEPI on postoperative day 0 is a viable strategy for nutritional management in this patient population.