Effectiveness of early enteral nutrition support in patients undergoing gastrointestinal perforation repair surgery within the enhanced recovery

Abstract

BACKGROUND

Gastrointestinal (GI) perforation (GP) repair is a surgical procedure to promptly seal perforations in the GI tract to prevent further leakage. After surgery, patients often experience a high metabolic state due to trauma, infection, and postoperative stress. In the Enhanced Recovery After Surgery (ERAS) protocol, early enteral nutrition is a key strategy for promoting postoperative recovery. Compared with parenteral nutrition, enteral nutrition more effectively meets the physiological needs of the GI system, promotes the recovery of gut function, and reduces the risk of GI infections.

AIM

To evaluate the clinical efficacy of early enteral nutrition support in patients undergoing GP repair within the ERAS protocol.

METHODS

This retrospective study analyzed 66 patients who underwent GP repair. Patients were divided into a control group (n = 32), managed with a traditional nutritional regimen, primarily consisting of total parenteral nutrition; and an observation group (n = 34), which included those who received early enteral nutrition support as part of the ERAS protocol. This study examined the time to first postoperative flatus and bowel movement, changes in nutritional and immune function, inflammatory markers on postoperative days 1 and 5, and adverse reactions.

RESULTS

The observation group had significantly shorter times to the first postoperative flatus and bowel movement than the control group (P < 0.05). On postoperative day 5, the observation group demonstrated higher nutritional and immune function levels than the control group (P < 0.05), while C-reactive protein levels were significantly lower (P < 0.05). The overall incidence of adverse reactions in the observation group was 8.82% (3/34), which was lower than the 28.13% (9/32) observed in the control group (P < 0.05).

CONCLUSION

Early enteral nutritional support facilitates GI recovery after GP repair. It improves nutritional status, enhances immune function, and attenuates inflammatory responses while also demonstrating a favorable safety profile.

Keywords: Enhanced Recovery After Surgery; Early enteral nutrition support; Gastrointestinal perforation repair surgery; Nutritional status; Postoperative gastrointestinal function

Core Tip: This retrospective study compared early enteral nutrition (Enhanced Recovery After Surgery [ERAS] protocol) with traditional parenteral nutrition in 66 patients undergoing gastrointestinal perforation repair. The observation group (n = 34) showed shorter times to first flatus and bowel movement, higher nutritional (prealbumin, albumin, hemoglobin) and immune markers (immunoglobulin A [IgA], IgM, IgG), and lower C-reactive protein levels on postoperative day 5 vs the control group (n = 32). Adverse reactions were lower in the observation group (8.82% vs 28.13%). Early enteral nutrition under ERAS improves recovery, nutritional status, immune function, and reduces inflammation with better safety.