INTRAOPERATIVE PLACEMENT OF THE NASOENTERIC FEEDING TUBE - A PRACTICAL ALTERNATIVE

Background: The provision of early postoperative enteral feeding may b e enhanced by the placement of enteral feeding access during celiotomy , but surgeons are often reluctant to pursue this option because of th e extra effort required. Methods: We conducted a retrospective review of our 2-year experience with 60 sequential intraoperative nasoenteric feeding-tube placements and included data on demographics, diagnosis, surgery, type of feeding tube, formula, tolerance, and complications. Our surgeons placed intraoperative nasoenteric feeding tubes at their discretion in a variety of subjects who were undergoing elective or u rgent celiotomies. Results: The surgeries largely involved the upper g astrointestinal tract, and feeding-tube placements were readily accomp lished. The majority of patients received enteral feedings within 3 po stoperative days and achieved feeding rates of 50 mL/h or greater. The average duration of feeding-tube use was 1 week, accounting for 399 f eeding days overall. There were no serious complications attributable to feeding-tube placement or use, but inadvertent tube removal by pati ents or staff was a limitation. Conclusions: Intraoperative placement of the nasoenteric feeding tube may be a reasonable option for treatin g the surgical patient at nutritional risk who faces a limited course of impaired oral intake postoperatively.