Status of Nutritional Support after Emergency Gastrointestinal Surgery in Korea: Retrospective Multicenter Study

Dae-Sang Lee, Youngeun Park, Kyoung Hoon Lim, Ye Rim Chang, Suk‐Kyung Hong, M. Kang, J. Bae, J. Jang, Y. Jo, Ki Hoon Kim, G. Lee
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Abstract

Purpose: Surgery itself causes an inflammatory response to an injury to the patient that leads to a stress metabolic state. Emergency gastrointestinal surgery may cause complications, such as ileus, bowel obstruction, ischemia, or anastomotic leakage, resulting in a delayed oral diet or poor overall nutrition. This study investigated the route of nutrition for patients who underwent emergency gastrointestinal surgery and when to provide nutrition after surgery. Materials and Methods: Ten hospitals collected data retrospectively on the nutritional status and nutritional status of patients undergoing emergency gastrointestinal surgery for one year from January to December 2016. The clinical outcomes of the nutrient supply method, duration of supply, and type of surgery were performed. The dates from the time of surgery to the start of enteral nutrition, oral nutrition, and parenteral nutrition were calculated. Results: Of 706 patients, there were 187 (26.5%) trauma patients, of which 63.5% were male. The onset of nutrition began after an average of 10.7 days postoperatively and after an average of 12.1 days of enteral nutrition. On average, it took 7.7 days to provide adequate calories, of which 63.3% had achieved adequate calories within a week. In the case of minimally invasive surgery, such as laparoscopic surgery, the adequate calorie supply time was five days, which was reached within one week. Conclusion: In a retrospective multicenter analysis, the patients who underwent emergency gastrointestinal surgery had a late start of oral or enteral nutrition, and the ratio of adequate calorie supply within a week was low. (Surg Metab Nutr 2020;11:1-6)
韩国紧急胃肠手术后的营养支持状况:回顾性多中心研究
目的:手术本身会引起对患者损伤的炎症反应,从而导致应激代谢状态。紧急胃肠手术可能引起肠梗阻、肠梗阻、缺血或吻合口漏等并发症,导致口腔饮食延迟或整体营养不良。本研究探讨急诊胃肠手术患者的营养途径及术后何时提供营养。材料与方法:回顾性收集10家医院2016年1 - 12月1年间急诊胃肠手术患者的营养状况及营养状况资料。观察营养供给方式、持续时间和手术类型的临床效果。计算从手术时间到开始肠内营养、口服营养和肠外营养的时间。结果:706例患者中,创伤患者187例(26.5%),其中男性占63.5%。术后平均10.7天后开始营养,平均12.1天后开始肠内营养。平均需要7.7天才能提供足够的热量,其中63.3%的人在一周内达到了足够的热量。在微创手术的情况下,如腹腔镜手术,足够的热量供应时间为5天,在一周内达到。结论:在一项多中心回顾性分析中,急诊胃肠手术患者口服或肠内营养开始较晚,且一周内提供充足热量的比例较低。(中华外科杂志2020;11:1-6)
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