Use this URL to cite or link to this record in EThOS: https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.697993
Title: Enhancing recovery in non-critical care emergency bowel resection
Author: Stupples, Caroline Elizabeth
ISNI:       0000 0004 5988 9297
Awarding Body: University of Northampton
Current Institution: University of Northampton
Date of Award: 2016
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Abstract:
Introduction: The aim of this study was to investigate the feasibility and safety of an enhanced recovery approach incorporating avoidance of routine post-operative nasogastric (NG) decompression and early oral fluids and diet when compared to traditional care in non-critical care (Level 0/1) patients following emergency bowel resection. Method: A single centre comparative observational study was used to compare outcomes between two existing parallel groups of Level 0/1 emergency bowel resection patients. Strict inclusion criteria governed eligibility. Groups were differentiated according to presence (Traditional care, TRAD) or absence (Enhanced care, ERP) of NG tube at the end of surgery. The primary study outcome was toleration of oral fluid and diet. Secondary outcomes were post-operative complications and length of hospital stay. Study endpoints were inpatient discharge home, transfer to another speciality, death, insertion/re- insertion of NG tube and re-operation. Results: Between October 2013 and February 2015, 61 patients (27 ERP, 34 TRAD) met the eligibility criteria. Study groups were comparable. On average, the ERP group tolerated oral fluids (p=0.001) and oral diet (p=0.019) significantly earlier than the TRAD group. No statistically significant differences were found between groups in incidence of post-operative complication (p=0.589), length of hospital stay (p=0.189) or study endpoints (p=0.386) Conclusion: An enhanced care approach incorporating avoidance of routine NG decompression and re-introduction of early oral fluid and diet is tolerated in Level 0/1 emergency bowel resection patients with no significant difference in post-operative complication or length of hospital stay when compared to traditional care. This supports the feasibility and safety of an enhanced care approach in this patient group although further research is required in relation to those with intra-operative ischaemia.
Supervisor: Campbell, Jacqueline Ann Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID: uk.bl.ethos.697993  DOI: Not available
Keywords: RD49 Surgical therapeutics. Preoperative and postoperative care ; RD544 Colon (Anatomy). Surgery
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