Balaji Pandian, j (2020) Prospective study on Role of Early Enteral Feeding in Gastric / Duodenal Perforation. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION: Perforation of gut is one of a common surgical emergency encountered in clinical practice. Patients with gastric / duodenal perforations presents with severe peritonitis and septicemia. Upper GI perforations need immediate repair mostly by Omental patch closure. Following surgical repair of the perforation patients will be observed postoperatively regarding the improvement of vitals and return of normal bowel movements and improvements in biochemical parameters for planning of introduction of oral feeds. OBJECTIVES: To derive conclusions about efficacy of EARLY ENTERAL FEEDING IN PATIENTS WITH GASTRIC/ DUODENAL PERFORATION and its impact on recovery of patients after surgery. PATIENTS AND METHODS: This prospective study was conducted in patients who got admitted with Gastric/Duodenal Perforation at Government Rajaji Hospital, Department of General Surgery, Madurai medical college, Madurai. All patients were evaluated with history, clinical examination and relevant laboratory and radiological investigations including X-ray chest and abdomen, ultrasound abdomen. Statistical analysis was performed with IBM SPSS version 16 (SPSS Inc., Chicago, IL). RESULTS: During study period, 50 patients with Gastric/Duodenal Perforation were selected randomly into two groups. Study group of 25 patients were randomly selected for starting Early Enteral Feeding (EEF) via Intra operatively inserted NasoJejunal (NJ) Tube from POD-1. Control group of 25 patients were started oral feeds post operatively after appearance of bowel sounds and passage of stools (POD 5-7). There is no statistically significant difference between the study and the control groups (p>0.05) regarding mean age, duration of Perforation, Manheim Peritonitis Index Score. Among the study group on an average, shifting out of ICU (on POD-2), appearance of bowel sounds (on POD 3), passage of flatus (on POD-4), removal of Ryle’s tube (on POD-5) happened one day prior to the control group. The clinical and biochemical parameters showed statistically significant improvement (p<0.05) in study group than the control group on POD-3. But there was no significant difference in clinical and biochemical parameters on POD-7 among both the groups. 60% of patients among the study group were without any major postoperative complications compared to only 12% among the control group. There is no significant difference (p>0.05) in mortality rate among the study group (8%) and the control group (12%). On an average patients under the study group got discharged from the hospital about 3 days prior to the control group which is statistically significant (p<0.05). CONCLUSION: Early Enteral Feeding in postoperative period is beneficial to patients with Gastric/ Duodenal perforation both in recovery evidenced by reducing the duration of stay and also in preventing major postoperative complications. There is no significant decrease in postoperative mortality among the Early Enteral fed patients.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221711102 |
| Uncontrolled Keywords: | Early Enteral Feeding, Gastric / Duodenal Perforation, Prospective study. |
| Subjects: | MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 10 Feb 2021 01:00 |
| Last Modified: | 10 Feb 2021 01:00 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/13961 |
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