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Patient-Controlled Nutrition After Abdominal Surgery: Novel Concept Contrary to Surgical Dogma

Annals of Coloproctology 2018년 34권 5호 p.253 ~ 258
김형욱, 강민구, 이성렬, 정경욱, Kim Hung-Dai, 전호경,
소속 상세정보
김형욱 ( Kim Hyung-Ook ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Surgery
강민구 ( Kang Min-Goo ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Surgery
이성렬 ( Lee Sung-Ryol ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Surgery
정경욱 ( Jung Kyung-Uk ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Surgery
 ( Kim Hung-Dai ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Surgery
전호경 ( Chun Ho-Kyung ) - Sungkyunkwan University School of Medicine Kangbuk Samsung Hospital Department of Surgery

Abstract


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.

키워드

Postoperative care; Diet; Nutritional support; Abdominal surgery; Appendectomy

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