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Enteral vs Parenteral Nutrition After Major Abdominal Surgery
An Even Match
Fabio Pacelli, MD;
Maurizio Bossola, MD;
Valerio Papa, MD;
Marina Malerba, MD;
Cristina Modesti, MD;
Antonio Sgadari, MD;
Rocco Bellantone, MD;
Giovanni Battista Doglietto, MD;
Cristina Modesti, MD;
for the EN-TPN Study Group
Arch Surg. 2001;136:933-936.
Hypothesis Immediate enteral feeding following major abdominal surgery reduces postoperative complications and mortality when compared with parenteral nutrition.
Design A prospective multicenter randomized trial.
Setting A university hospital department of digestive surgery.
Patients and Interventions Two hundred forty-one malnourished patients undergoing major elective abdominal surgery were randomly assigned to receive, after surgery, either enteral (enteral nutrition group: 119 patients) or parenteral nutrition (total parenteral nutrition group: 122 patients). The patients were monitored for postoperative complications and mortality.
Results The rate of major postoperative complications was similar in the enteral and parenteral groups (enteral nutrition group: 37.8%; total parenteral nutrition group: 39.3%; P was not significant), as were the overall postoperative mortality rates (5.9% and 2.5%, respectively; P was not significant).
Conclusion The present study failed to demonstrate that enteral feeding following major abdominal surgery reduces postoperative complications and mortality when compared with parenteral nutrition.
From the Departments of Surgical Sciences (Drs Pacelli, Bossola, Papa, Malerba, Bellantone, and Doglietto), Anesthesiology (Dr Modesti), and Internal Medicine and Geriatrics (Dr Sgadari), Catholic University of the Sacred Heart, Rome, Italy.
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