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KMID : 1141920180340050253
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Annals of Coloproctology
2018 Volume.34 No. 5 p.253 ~ p.258
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Patient-Controlled Nutrition After Abdominal Surgery: Novel Concept Contrary to Surgical Dogma
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Kim Hyung-Ook
Kang Min-Goo
Lee Sung-Ryol
Jung Kyung-Uk
Kim Hung-Dai
Chun Ho-Kyung
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Abstract
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Purpose: According to surgical dogma, patients who are recovering from general anesthesia after abdominal surgery should begin with a clear liquid diet, progress to a full liquid diet and then to a soft diet before taking regular meals. We propose patient-controlled nutrition (PCN), which is a novel concept in postoperative nutrition after abdominal surgery.
Methods: A retrospective pilot study was conducted to evaluate the feasibility and effects of PCN. This study was carried out with a total of 179 consecutive patients who underwent a laparoscopic appendectomy between August 2014 and July 2016. In the PCN group, diet was advanced depending on the choice of the patients themselves; in the traditional group, diet was progressively advanced to a full liquid or soft diet and then a regular diet as tolerated. The primary endpoints were time to tolerance of regular diet and postoperative hospital stay.
Results: Time to tolerance of a regular diet (P < 0.001) and postoperative hospital stay (P < 0.001) showed statistically significant differences between the groups. Multivariate analysis using linear regression showed that the traditional nutrition pattern was the only factor associated with postoperative hospital stay (P < 0.001). Multivariate analysis using logistic regression showed that traditional nutrition was the only risk factor associated with prolonged postoperative hospital stay (≥3 days).
Conclusion: After abdominal surgery, PCN may be a feasible and effective concept in postoperative nutrition. In our Early Recovery after Surgery program, our PCN concept may reduce the time to tolerance of a regular diet and shorten the postoperative hospital stay.
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KEYWORD
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Postoperative care, Diet, Nutritional support, Abdominal surgery, Appendectomy
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