Comparison of Outcome in Early Vs Conventional Feeding after Colostomy Closure in Paediatric Population
DOI:
https://doi.org/10.61919/jhrr.v4i1.641Keywords:
Colostomy Closure, Early Enteral Feeding, Pediatric Surgery, Postoperative Complications, Postoperative Recovery, Randomized Controlled Trial, Surgical Nutrition, Hospital Stay, Pediatric PatientsAbstract
Background: The traditional practice of delaying enteral feeding after pediatric colostomy closure has been a subject of reconsideration in the wake of emerging evidence suggesting the benefits of early enteral nutrition. The hypothesis driving this shift stems from the understanding that early feeding may enhance recovery by improving gut function and reducing hospital stay, which is particularly significant in the pediatric population where rapid return to normal activities and minimizing hospital-associated stress are crucial.
Objective: This study aimed to compare the outcomes of early enteral feeding versus conventional feeding protocols post-colostomy closure in pediatric patients, focusing on parameters such as the incidence of postoperative complications, the duration of hospital stay, and overall recovery.
Methods: Conducted as a randomized controlled trial at the Department of Pediatric Surgery, Children Hospital, Lahore, this study enrolled 70 pediatric patients, evenly divided into two groups: early enteral feeding (Group A) and conventional feeding (Group B). Both groups were meticulously matched for age, weight, and gender to ensure comparability. The study meticulously recorded and analyzed postoperative outcomes including anastomotic leakage, vomiting, upper respiratory tract infections (URTI), wound infections, and other complications using chi-square and t-tests for statistical significance.
Results: The mean age of patients was 6.67 ± 3.42 years, with a balanced distribution between the groups (p = 0.917). In Group A, 8.6% experienced anastomotic leakage compared to 11.4% in Group B; vomiting occurred in 11.4% of Group A and 8.6% of Group B; URTI was noted in 2.9% of Group A versus 14.3% in Group B; wound infection rates were 8.6% for Group A and 14.3% for Group B. The average post-operative hospital stay significantly favored Group A at 4.26 ± 0.43 days versus 7.05 ± 0.32 days for Group B (p = 0.0001).
Conclusion: Early enteral feeding after pediatric colostomy closure significantly reduces the hospital stay without increasing the risk of postoperative complications, suggesting a beneficial role in pediatric surgical recovery. This study supports the integration of early feeding protocols into postoperative care for pediatric colostomy patients, contributing to the evolving practice of pediatric surgery.
Downloads
References
Smith A, Anders M, Auffenberg G, Daneshmand S, Elllimootil C, Fellows J, editors. Optimizing outcomes in urologic surgery: postoperative. Am Urol Assoc; 2018.
Rentea RM, Snyder CLJHsD, Disorders A. Early and late complications following pull-through operation for Hirschsprung’s disease. 2019:383-401.
Navaneethan U, Lourdusamy DJGEC. Endoscopic stricturotomy and strictureplasty. 2022;32:687-97.
Joseph SJSE. 2022 Scientific Session of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), Denver, Colorado, 16–19 March 2022: Posters. 2022;36:S70-S218.
Pironi L, Corcos O, Forbes A, Holst M, Joly F, Jonkers C, et al. Intestinal failure in adults: recommendations from the ESPEN expert groups. 2018;37(6):1798-809.
Douglas MJ, Khurrum M, Joseph B. Nutrition considerations in emergency surgery. The Acute Management of Surgical Disease: Springer; 2022. p. 505-30.
Stene C, Jeppsson BJDD, treatment. The importance of enteral nutrition. 2019:793-811.
THIRUVIKKARAMAN M. The Retrospective study of Scoring in Acute Intestinal Obstruction-Timing of Surgery. 2020.
Proulx J. Nutrition in critically ill animals. The veterinary ICU book: CRC Press; 2020. p. 202-17.
Carson JS, Khosrozadeh H, Norbury WB, Herndon DN. Nutritional needs and support for the burned patient. Total burn care: Elsevier; 2018. p. 287-300. e2.
Javed H, Gummon A, Rana M, Shoukat RJEJoHS. Early vs Traditional Postoperative Feeding in Patients Undergoing Small Bowel Surgery. 2023;9(3):36-42.
Noureen S, Sharif M, Naumeri F, Fatima N, Noor-ul-Haq MJTPMJ. Outcome of Enhanced Recovery after Surgery (ERAS) in pediatric population undergoing gastrointestinal surgery. 2023;30(09):1096-101.
Zamora IJ, Ghani MOA, Heiss K. Enhanced Recovery After Surgery Protocols (ERAS): The Next Generation of Perioperative Quality Improvement, Safety, and Innovation. Fundamentals of Pediatric Surgery: Springer; 2022. p. 67-77.
Rattray M, Roberts S, Desbrow B, Wullschleger M, Robertson T, Hickman I, et al. A qualitative exploration of factors influencing medical staffs’ decision-making around nutrition prescription after colorectal surgery. 2019;19:1-11.
Coleman E, Radix AE, Bouman WP, Brown GR, De Vries AL, Deutsch MB, et al. Standards of care for the health of transgender and gender diverse people, version 8. 2022;23(sup1):S1-S259.
Weaver MS, Anderson V, Beck J, Delaney JW, Ellis C, Fletcher S, et al. Interdisciplinary care of children with trisomy 13 and 18. 2021;185(3):966-77.
Johnson LP, Asigbee FM, Crowell R, Negrini AJCo. Pre‐surgical, surgical and post‐surgical experiences of weight loss surgery patients: a closer look at social determinants of health. 2018;8(4):265-74.
Lewis SJ, Egger M, Sylvester PA, Thomas SJB. Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. 2001;323(7316):773.
Fathy M, Khedre MM, Nagaty MA, Zaghloul NMJAoPS. Enhanced recovery protocols versus traditional methods after resection and reanastomosis in gastrointestinal surgery in pediatric patients. 2018;14(4):214–7-–7.
KHAN FNJM. Comparison of early complications of elective tracheostomy with early complications of emergency tracheostomy. 2019.
uz Zaman MJP. ABSTRACTS-38th ANNUAL RSP CONFERENCE-KARACHI (25th-27th November 2022). 2022;32(4).
Gajakosh P. Prophylactic Antibiotic and Post Operative Surgical Wound Infection: Rajiv Gandhi University of Health Sciences (India); 2018.
Tebala GD, Gordon-Dixon A, Imtiaz M, Shrestha A, Toeima MJM-iS. Enhanced recovery after rectal surgery: what we have learned so far. 2018;2:32.
Khan NA, Roy Choudhury S, Yadav PS, Prakash R, Patel JNJPsi. Role of nasogastric tube in children undergoing elective distal bowel surgery. 2017;33:229-34.
Pan H, Hu X, Yu Z, Zhang R, Zhang W, Ge JJIc, et al. Use of a fast-track surgery protocol on patients undergoing minimally invasive oesophagectomy: preliminary results. 2014;19(3):441-7.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Sulman Bajwa, Ghulam Mohy-Ud Din, Aziz Ahmad Chattha, Muhammad Zubair Shoukat, Professor Muhammad Saleem, Imran Hashim
This work is licensed under a Creative Commons Attribution 4.0 International License.
Public Licensing Terms
This work is licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). Under this license:
- You are free to share (copy and redistribute the material in any medium or format) and adapt (remix, transform, and build upon the material) for any purpose, including commercial use.
- Attribution must be given to the original author(s) and source in a manner that is reasonable and does not imply endorsement.
- No additional restrictions may be applied that conflict with the terms of this license.
For more details, visit: https://creativecommons.org/licenses/by/4.0/.
