Safety and Effectiveness of Early Feeding After Bowel Anastomosis in Neonates or Infants
Condition: Enteral Feeding; Neonate; Infant; Intestinal Anastomosis Complication
Study type: Interventional

Summary: 
      The study is primary designed to evaluate the safety and effectiveness of early feeding after
      bowel anastomosis, and observe the effect of early postoperative feeding on promoting
      postoperative rehabilitation and reducing parenteral nutrition
    

Detailed description: 
      Intestinal anastomosis is a common operation for the treatment of digestive tract diseases of
      newborns and infants. It is not be defined that when should begin oral feeding after
      intestinal anastomosis. Poor anastomotic healing or anastomotic leakage is the most serious
      complication after intestinal anastomosis, which often leads to severe abdominal infection,
      peritonitis and even death. Nowadays, it is believed that the causes of poor anastomotic
      healing or anastomotic leakage are various, including contaminated during the operation, the
      blood supplyment of the bowel edges at both ends of the anastomosis, anemia, anastomosis
      technique, type of surgery (selective or emergency), and anastomotic tension . The
      traditional view is that early feeding may increase the anastomotic tension, which may lead
      to poor anastomotic healing or leakage, so a lot of surgeons often take a fasting for 4-5
      days after intestinal anastomosis to ensure good anastomotic healing, however there is no
      enough evidence for this view. On the contrary, the current research confirms that after
      intestinal anastomosis, under fasting conditions, the digestive system still has 1-2 liters
      of fluid through the anastomosis, so even if it is given postoperative oral feeding, It would
      not excessively increase the digestive fluid through the anastomosis. Obviously, the early
      guess that the anastomotic tension is increased is lacking in theoretical evidence. In recent
      years, with the in-depth study of intestinal function, intestinal mucosal barrier function
      and intestinal flora, early enteral nutrition has stretched more and more attention, which is
      believed could stimulate intestinal digestive fluid secretion, promote intestinal mucosal
      metabolism and repair, avoid intestinal villi atrophy, reduce intestinal bacterial
      translocation, promote intestinal function recovery and intestinal peristalsis. Postoperative
      intestinal obstruction is also an important reason for hindering early enteral nutrition, but
      current research believes that postoperative intestinal obstruction is often temporary, and
      in most cases will be relieved 4-8 hours after surgery. European Society of Parenteral
      Enteral Nutrition (ESPEN ) recommended that enteral nutrition should be performed within 24
      hours after intestinal anastomosis, but it needs to be fully evaluated according to the
      children's own tolerance and the type of surgery. A large number of studies and meta-analysis
      have confirmed that early enteral nutrition is safe and feasible after intestinal anastomosis
      in adults, but there are still few studies in children, especially whether early enteral
      surgery can be performed after intestinal anastomosis is currently rarely reported in
      neonates and infants. This study evaluated the feasibility and effectiveness of early oral
      enteral nutrition in neonates and infants after intestinal anastomosis through a prospective
      study.
    

Intervention name(s): early oral feeding or early enteral nurtrion
Intervention type(s): Dietary Supplement
Intervention description(s): The patients in the experimental group were fed orally within 24-48 hours after intestinal anastomosis. Start taking it at 24-48 hours after surgery until discharged. The initial dose is 1ml/kg.h, which is gradually increased to 100ml/kg daily.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The study is a prospective, randomized controlled clinical study. A total of 285 inpatients (95 experimental groups and 190 control groups) were enrolled to evaluate the safety and effectiveness of early feeding in neonates and infants after intestinal anastomosis
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: oral feeding; early enteral nurtrion; Intestinal anastomosis; neonate; infant