Early enteral nutrition after head and neck surgery with free tissue transfer reconstruction
Early enteral nutrition after head and neck surgery with free tissue transfer reconstruction
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头颈手术后早期肠内营养与游离组织移植重建
DOI：
10.1016/j.anl.2021.06.004
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发表时间：
2022
影响因子：
1.7
通讯作者：
Asada Yukinori
中科院分区：
文献类型：
--
作者：
Imai Takayuki;Saijo Satoshi;Fujii Keitaro;Nakazato Akira;Nakamura Kazuki;Miyakura Yuya;Yamazaki Tomoko;Goto Takahiro;Asada Yukinori
早期肠内营养对促进术后恢复至关重要。然而，到目前为止，没有详细的研究已经进行了早期肠内营养的可行性，在接受头颈部手术的患者与自由组织转移重建（HNS-FTTR）和困难的危险因素与早期肠内nutrition.MethodsWe回顾性分析了102例谁接受HNS-FTTR在我们的机构，61进行了自由空肠重建（FJ）和41没有。我们调查了在24和48小时内手术后的早期肠内营养的实现和肠内营养后，其启动后7天内surgical.Results81/102（79.4%）和99/102（97.1%）的患者，分别在24和48小时内开始肠内营养。早期肠内营养困难21例（20.6%）。多因素分析显示FJ是早期肠内营养困难的独立危险因素（OR：4.054，P = 0.042）。多因素分析显示，失血量≥158 mL是影响FJ患者早期肠内营养的独立危险因素（OR = 3.505，P = 0.044）。FJ是早期肠内营养困难的重要危险因素。术中失血量增加是FJ患者早期肠内营养困难的一个重要风险因素;因此，在这种情况下，应仔细监测患者的腹部症状和胃残留量。
ObjectiveEarly enteral nutrition is essential for enhancing recovery after surgery. However, to date, no detailed study has been conducted on the feasibility of early enteral nutrition in patients undergoing head and neck surgery with free tissue transfer reconstruction (HNS-FTTR) and the risk factors for difficulty with early enteral nutrition.MethodsWe retrospectively analyzed 102 patients who underwent HNS-FTTR at our institution; 61 underwent free jejunal reconstruction (FJ) and 41 did not. We investigated the achievement of early enteral nutrition within 24 and 48 h after surgery and the discontinuation of enteral nutrition after its initiation within 7 days after surgery.ResultsEnteral nutrition could be started in 81/102 (79.4%) and 99/102 (97.1%) patients within 24 and 48 h, respectively. Cases of difficulty with early enteral nutrition accounted for 21/102 (20.6%) patients. The multivariate analysis revealed that FJ was a significant independent risk factor for difficulty with early enteral nutrition (odds ratio: 4.054,P= 0.042). The risk factors for difficulty with early enteral nutrition in patients who underwent FJ were also investigated, and the multivariate analysis showed that blood loss of ≥158 mL was a significant independent risk factor (odds ratio: 3.505,P= 0.044).ConclusionsEarly enteral nutrition seemed to be provided with no problems in patients without FJ. FJ was a significant risk factor for difficulty with early enteral nutrition. Increased intraoperative blood loss was a significant risk factor for difficulty with early enteral nutrition in patients undergoing FJ; therefore, patients’ abdominal symptoms and gastric residual volume should be carefully monitored in such cases.