Early enteral nutrition in neonates with partial gastrectomy: a multi-center study.

BACKGROUND AND OBJECTIVES: Compared with total parenteral nutrition (TPN), enteral nutrition is more suitable for patients post-operatively. Our aim was to determine the safety and feasibility of early enteral nutrition (EEN) using a jejunum feeding tube in neonates after undergoing a partial gastrectomy.

METHODS AND STUDY DESIGN: This was a retrospective review of 46 patients who underwent partial gastrectomies for gastric perforation in our hospital. These patients were categorized into two groups (EEN group [n=24 patients], a jejunal feeding tube was inserted during surgery; and a control group [n=22 patients], a jejunal feeding tube was not placed). Differences in operative time, time to first defecation post-operatively, time to first oral feeding post-operatively, length of hospital stay post-operatively, nutrition indices, and post-operative complications (died due to septic shock, cholestasis, pneumonia, abdominal distension, and diarrhea) were reviewed.

RESULTS: There were no significant differences in the operative time and the time to first oral feeding post-operatively between the two groups; however, the time to first defecation post-operatively in the EEN group and the hospital length of stay post-operatively for the EEN group were significantly shorter than the control group. The levels of albumin, retinol binding protein, and prealbumin were not significantly different between the two groups pre-operatively and 14 days postoperatively. The incidence of cholestasis and abdominal distention in the EEN group was significantly lower than the control group.

CONCLUSION: EEN using a jejunal feeding tube in neonates who have undergone a partial gastrectomy for gastric perforation is safe, easy, and has fewer complications than TPN.