Impact of Various Types of Artificial Nutrition on Postoperative Complications after Major Surgery of Upper Gastrointestinal Tract

Overview

Background:
The present rationale appears to prefer early postoperative enteral nutrition to total parenteral nutrition. But no clear conclusions exist for demonstrating the clinical benefit of early postoperative enteral nutrition in patients after the major surgical resections of upper gastrointestinal tract.

Aim:
To compare the clinical impact of various types of the artificial nutrition by comparison of the postoperative complications.

Methods:
Prospective, randomized, controlled clinical trial. Sixty-two patients were analyzed. In the group I (21 patients) the total parenteral nutrition was received, in the group II (20 patients) the standard enteral nutrition was received, in the group III (21 patients) the enteral nutrition enriched with glutamin, arginin and ω-3 fatty acids was received. Both enteral feedings were given early. All three nutritional regiments were isocaloric and isoproteinaceus.

Results:
The postoperative complications were in 31 patients overall (11, 11, 9 patients in the each group I, II, III). Three patients died in the group I, 2 patients in the group II, and 1 patient in the group III. There were no significance differences (p < 0,05) in postoperative complications, both infectious and non-infectious reasons.

Conclusion:
The study has shown no impact of various type of artificial nutrition on clinical outcome in patients after major resections of upper gastrointestinal tract. There was no significant difference in infectious complications in the groups with enteral feeding. The combination of enteral and parenteral nutrition appears as optimum after major surgery of the upper gastrointestinal tract. It is necessary to realize more extensive studies of homogenous patients to find out the benefit of various types of arteficial nutrition in postoperative period.

Key words:
artificial nutrition – major surgery – postoperative complications – early enteral nutriton – immunonutrition