Archives of Surgery
Enteral vs parenteral nutrition after major abdominal surgery

Arch Surg 2001; 136:933-6

Pacelli F, Bossola M, Papa V, Malerba M, Modesti C, Sgadari A, Bellantone R, Doglietto GB, Modesti C; EN-TPN Study Group.

Department of Digestive Surgery, Istituto di Clinica Chirurgica, Catholic University School of Medicine, Largo A. Gemelli, 8, 00168 Rome, Italy.

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.