Nutritional management of anastomotic leakage after colorectal cancer surgery using elemental diet jelly.
OBJECTIVE
Anastomotic leakage is major complication of colorectal surgery. Total parenteral nutrition (TPN) and fasting are conservative treatments for leakage in the absence of peritonitis in Japan. Elemental diet (ED) jelly is a completely digested formula and is easily absorbed without secretion of digestive juices. The purpose of this study was to assess the safety of ED jelly in management of anastomotic leakage.


METHODS
Six hundred and two patients who underwent elective surgery for left side colorectal cancer from January 2008 to December 2011 were included in the study. Pelvic drainage was performed for all patients. Sixty-three (10.5%) patients were diagnosed with an anastomotic leakage, and of these, 31 (5.2%) without diverting stoma were enrolled in this study.


RESULTS
Sixteen patients received TPN (TPN group) and 15 patients received ED jelly (ED group). The duration of intravenous infusion was significantly shorter in the ED group than in the TPN group (15 days versus 25 days, P= 0.008). In the TPN group, catheter infection was occurred in 2 patients who required re-insertion of the catheter.


CONCLUSIONS
Conservative management of anastomotic leakage after colorectal surgery with ED jelly appears to be a safe and useful approach.
A
A
Ishibe
M
M
Ota
A
A
Kanazawa
J
J
Watanabe
K
K
Tatsumi
K
K
Watanabe
T
T
Godai
S
S
Yamagishi
S
S
Fujii
Y
Y
Ichikawa
C
C
Kunisaki
I
I
Endo
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000175:diagnosis / Q000178:diet therapy / Q000209:etiology / Q000628:therapy*; D003082:Colectomy / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D005526:Food, Formulated / Q000009:adverse effects; D005782:Gels; D006801:Humans; D008297:Male; D008875:Middle Aged; D010289:Parenteral Nutrition, Total / Q000009:adverse effects; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D005782:Gels