Nutritional support and oral intake after gastric resection in five northern European countries.
BACKGROUND
A comprehensive evidence base for perioperative care in upper gastrointestinal (GI) surgery is lacking. Little is known about the routines currently practiced in the absence of such evidence. We describe postoperative practice after gastric resections in five northern European countries. METHOD AND SETTING: Questionnaire survey in all major digestive surgical centres in Scotland, the Netherlands, Denmark, Sweden and Norway.


RESULTS
76% of all centres (n = 200/263) responded. Routines varied extensively both nationally and between countries. No uniformity was traced although a conservative trend was noticeable in the use of nasogastric decompression tubes and 'nil-by-mouth' regimens. Nutritional support during the first 5 days is generally offered in Denmark, but not in Scotland. Drinking at will is generally allowed in Denmark and Norway by the first postoperative day. Eating at will is uniformly restricted.


CONCLUSIONS
The paucity of evidence is reflected by the marked heterogeneity in practice. Large groups of patients may be treated suboptimally. Best perioperative care for these patients must be defined and documented. Especially, the role of early oral intake at will in upper GI surgery needs to be clarified by sufficiently powered trials.
Lassen
Kristoffer
K
Department of Gastrointestinal Surgery, University Hospital of Northern Norway, Tromsø, Norway. lassen@umn.no
Dejong
Cornelis H C
CH
Ljungqvist
Olle
O
Fearon
Ken
K
Andersen
Jens
J
Hannemann
Pascal
P
von Meyenfeldt
Maarten F
MF
Hausel
Jonatan
J
Nygren
Jonas
J
Revhaug
Arthur
A
D003718:Denmark; D004435:Eating; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D009426:Netherlands; D009664:Norway; D018529:Nutritional Support / Q000379:methods*; D019990:Perioperative Care / Q000379:methods*; D012606:Scotland; D011795:Surveys and Questionnaires; D013548:Sweden; D016896:Treatment Outcome