https://scholars.lib.ntu.edu.tw/handle/123456789/457160
Title: | Randomized trial of oral versus enteral feeding for patients with postoperative pancreatic fistula after pancreatoduodenectomy | Authors: | JIN-MING WU TING-CHUN KUO Chen H.-A. CHIEN-HUI WU Lai S.-R. CHING-YAO YANG Hsu S.-Y. Ho T.-W. WEI-CHIH LIAO YU-WEN TIEN |
Issue Date: | 2019 | Publisher: | John Wiley and Sons Ltd | Journal Volume: | 106 | Journal Issue: | 3 | Start page/Pages: | 190-198 | Source: | British Journal of Surgery | Abstract: | Background: Whether continued oral feeding may have a negative impact on healing of postoperative pancreatic fistula (POPF) is unclear. The aim was to test the hypothesis that oral feeding is non-inferior to enteral feeding in closure of POPF after pancreatoduodenectomy, and to clarify the effects of oral feeding on the duration and grade of POPF. Methods: This multicentre, non-inferiority randomized trial of oral or enteral feeding of patients with POPF after pancreatoduodenectomy recruited patients between August 2013 and September 2016. The primary efficacy outcome was the 30-day fistula closure rate. The prespecified non-inferiority margin was 15 per cent. Other efficacy outcomes included grade of fistula, and hospital stay and costs. Results: A total of 114 patients were included, and received oral (57) or enteral (57) feeding. The two groups were balanced in baseline characteristics and no patient was lost to follow-up. In intention-to-treat analysis, oral feeding was non-inferior to enteral feeding in terms of 30-day fistula closure rate (88 versus 89 per cent respectively; difference –1·8 per cent, lower limit of 95 per cent c.i. –14·4 per cent; P = 0·020 for non-inferiority). Compared with enteral feeding, oral feeding significantly reduced hospital costs and duration of stay. No significant differences were noted in the number of patients whose POPF evolved into grade B/C, or other outcomes. Conclusion: Oral feeding in patients with POPF after pancreatoduodenectomy did not increase the duration or grade of POPF, and was associated with reduced duration of stay and hospital costs. Registration number: NCT01755260 (http://www.clinicaltrials.gov). ? 2019 BJS Society Ltd Published by John Wiley & Sons Ltd |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85061150052&doi=10.1002%2fbjs.11087&partnerID=40&md5=d11a70233ed09cc931b8e1e4d41d8435 https://scholars.lib.ntu.edu.tw/handle/123456789/457160 |
ISSN: | 0007-1323 | DOI: | 10.1002/bjs.11087 | SDG/Keyword: | amylase; cholecystokinin; abdominal abscess; adult; Article; computer assisted tomography; controlled study; enteric feeding; female; follow up; gastrojejunostomy; hospital cost; hospitalization; human; length of stay; major clinical study; male; middle aged; multicenter study; oral feeding; pancreas fistula; pancreas secretion; pancreaticoduodenectomy; pancreaticojejunostomy; parenteral nutrition; postoperative complication; priority journal; randomized controlled trial; recurrent disease; stomach paresis; clinical trial; comparative study; eating; pancreas fistula; pancreaticoduodenectomy; postoperative care; postoperative complication; procedures; statistics and numerical data; treatment outcome; Eating; Enteral Nutrition; Female; Humans; Length of Stay; Male; Middle Aged; Pancreatic Fistula; Pancreaticoduodenectomy; Postoperative Care; Postoperative Complications; Treatment Outcome |
Appears in Collections: | 醫學系 |
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