Early Enteral Nutrition Could Reduce Risk of Recurrent Leakage After Definitive Resection of Anastomotic Leakage After Colorectal Cancer Surgery

Colorectal Cancer
25/09/2020

World J Surg. 2020 Sep 25. doi: 10.1007/s00268-020-05787-6. Online ahead of print.

ABSTRACT

BACKGROUND: The present study aimed to evaluate the effect of early enteral nutrition (EEN) after definitive resection of anastomotic leakage (DRAL) resulting from a sigmoid colon or rectal cancer radical resection.

METHODS: This was a prospective cohort study performed at our center. From January 2014 to May 2016, every patient received a standard postoperative nutritional protocol (SPNP) after DRAL and was included into SPNP group. From June 2016 to December 2018, all patients received an EEN after DRAL and were included into EEN group. The effect of postoperative EEN was evaluated.

RESULTS: There were a final total of 133 patients enrolled in our study. There were 70 patients in the SPNP group, and 63 patients in the EEN group. There were 12 cases (19.05%) with a recurrent leakage in the EEN group, and 28 cases (40%) in the SPNP group. The recurrent rate was associated with EEN (HR = 0.417, 95% CI 0.196-0.890, p = 0.024). The median defecation time in the EEN group was 5(4-7) days, while in the SPNP group was 7(6-8.25) days. The defecation was associated with EEN (HR = 1.588, 95% CI 1.080-2.336, p = 0.019), as well.

CONCLUSION: EEN could reduce the recurrent leakage rate and defecation time after definitive resection of anastomotic leakage resulting from sigmoid colon or rectal cancer radical resection.