Application of early oral feeding after primary intestinal anastomosis in infants:a real-world study
Objective To evaluate the clinical application of early oral feeding(EOF)after primary intestinal anastomosis in infants.Methods From October 2020 to May 2022,the medical records were collected from 555 infants undergoing primary intestinal anastomosis at 51 pediatric surgery centers.Based upon initial oral feeding time was less or more than 48h,they were assigned into two groups of EOF(n=116)and traditional oral feeding(TOF,n=439).Two groups were propensity score matched(PSM,1∶2)according to disease distribution,anastomotic site,gender,mini-invasive procedure,operative age and weight for minimizing bias.Finally 109 EOF and 200 TOF samples were successfully matched.Postoperative recovery and complications were compared between two groups by Mann-Whitney U,chi-square or Fisher exact test after PSM.Results The rates of overall complication and vomiting were greater in EOF group than those in TOF group(20.2％vs 11.0％,x2=4.87,P=0.027;9.2％vs 2.0％,x2=6.82,P=0.009).However,no inter-group differences existed in the incidences of abdominal distension,diarrhea,hematochezia or anastomotic leakage(P＞0.05).Also no inter-group difference existed in the rate of ceasing oral feeding due to complications.Durations of total parenteral nutrition(TPN),parenteral nutrition(PN)and postoperative hospitalization stay were significantly shorter in EOF group than those in TOF group[2.00(1.00,2.50)vs 5.00(3.00,6.00),Z=-10.17,P＜0.001;6.00(5.00,8.00)vs 9.00(6.00,13.00),Z=-5.05,P＜0.001;10.00(7.00,14.00)vs 14.00(10.00,17.00),Z=-5.62,P＜0.001].No inter-group differences existed in weight,serum albumin or serum prealbumin(P＞0.05).Conclusions EOF after primary intestinal anastomosis may elevate the rates of overall complications and vomiting in infants.However,it does not increase the incidence of serious complications,such as leakage.Also EOF may minimize the use of PN and shorten hospital stay.
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