Effects of early enteral nutrition on gastrointestinal function recovery and nutritional status after gastrointestinal surgery in children

Zhifeng Mo, Lubin Yan, Wei Zhang, Hanzhong He, Shaomin Huang, Wenbin Yang


Background: Young children are at a developmental stage, and any change in their body growth/development and nutritional status during this period has a direct impact on the prognosis of a specific disease. Clinically, most of the pediatric patients receiving an abdominal surgery are children with congenital malformations of the digestive system. They often have compromised nutritional status after the surgery due to factors including surgical trauma and stress reaction. Therefore, reasonable nutrition support has become a required intervention. In this prospective study, we investigated the influence of early enteral nutrition (EEN) on gastrointestinal (GI) function recovery and nutritional status after GI surgery in children.
Methods: A total of 60 children with GI diseases undergoing surgical treatment in our center from January 2017 to December 2018 were enrolled in this study. They were randomly divided into the control group and the EEN group according to the order of admission. No EEN was applied in the control group; in contrast, the EEN group received EEN via percutaneous endoscopic jejunostomy (PEJ) tube and postoperative jejunostomy tube. The recovery of GI function, changes in biochemical indicators within 7 days after surgery, postoperative nutritional status, and complications were compared between these two groups.
Results: After the surgery, the time to eating solid food and the time to first flatus/defecation were significantly shorter in the EEN group than in the control group (all P<0.05). Serum albumin (ALB), potassium, and serum calcium levels in the EEN group were significantly higher than those in the control group 7 days after surgery (all P<0.05). In the EEN group, the mean EN support time was 7.6±2.4 days, and the duration of jejunostomy feeding lasted 45.1±4.2 days. During the jejunostomy feeding, the body mass grew at a rate of 18.4±2.7 g/d in 11 newborns. Five children in the EEN group developed postoperative complications (mild in 4 cases and severe in 1 case).
Conclusions: Proper EEN after a GI surgery can increase the survival rate, accelerate the recovery of GI function, and improve the nutritional status in pediatric patients. This intervention can be further applied in clinical settings.