Chatterjee 2012.
Methods | Randomised controlled trial Study conducted April 2008 to March 2010 |
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Participants | 120 participants (60 in each group). Gastric, small bowel, large bowel and uncomplicated simple biliary‐enteric anastomosis. Route of feeding: oral Mean age (SD): 38.18 (11.9) (intervention group), 36.23 (12.88) (control group) Sex ratio (M:F): 42:18 (intervention group), 46:14 (control group) |
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Interventions | Intervention group: oral liquids (25 mL/hour) started within 24 hours of operation with clamping the NGT and the feed was increased by 25 mL/hour at 12‐hour intervals. When patient tolerated liquid diet, NGT removed and semi‐solid diet and then normal oral diet were started to reach nutritional goal (25 kcal/kg/day). Control group: kept NBM and were then fed 48‐72 hours after or more following enteric anastomosis depending upon return of full peristaltic sounds. NGT removed when output was less than 20 mL to 30 mL/day and there was no paralytic ileus. Gradually shifted to semi‐solid and then to solid normal diet. |
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Outcomes | Wound infection, anastomotic leakage, mortality, LoS, nausea and vomiting | |
Notes | Country of study: India | |
Risk of bias | ||
Bias | Authors' judgement | Support for judgement |
Random sequence generation (selection bias) | Unclear risk | No information provided |
Allocation concealment (selection bias) | Unclear risk | No information provided |
Blinding of participants (performance bias) All outcomes | High risk | No reports of attempts to blind participants. Participants are unlikely to be adequately blinded with an intervention of this nature. |
Blinding of personnel (performance bias) All outcomes | High risk | No reports of attempts to blind personnel. Personnel are unlikely to be adequately blinded with an intervention of this nature. |
Blinding of outcome assessor (detection bias) ‐ wound infections | High risk | Blinding of outcome assessor not discussed. Outcome assessor unlikely to be adequately blinded with an intervention of this nature. |
Blinding of outcome assessor (detection bias) ‐ intraabdominal abscesses | Unclear risk | NA ‐ not assessed |
Blinding of outcome assessor (detection bias) ‐ postoperative complications e.g. acute myocardial infarction, thrombosis or pneumonia | High risk | (Respiratory tract infection, urinary tract infection, incidence of re‐exploration) Blinding of outcome assessor not discussed. Outcome assessor unlikely to be adequately blinded with an intervention of this nature. |
Blinding of outcome assessor (detection bias) ‐ anastomotic leakage/dehiscence | High risk | Blinding of outcome assessor not discussed. Outcome assessor unlikely to be adequately blinded with an intervention of this nature. |
Blinding of outcome assessor (detection bias) ‐ mortality | Low risk | Blinding of outcome assessor not discussed. Outcome assessor unlikely to affect this outcome. |
Blinding of outcome assessor (detection bias) ‐ adverse events (e.g. nausea, vomiting, abdominal distention, aspiration, tube blockage and any other adverse events | High risk | (Vomiting and nausea) Blinding of outcome assessor not discussed. Outcome assessor unlikely to be adequately blinded with an intervention of this nature. |
Blinding of outcome assessor (detection bias) ‐ length of hospital stay | High risk | Blinding of outcome assessor not discussed. Outcome assessor unlikely to be adequately blinded with an intervention of this nature. |
Incomplete outcome data (attrition bias) All outcomes | Low risk | Less than 10% missing data. |
Selective reporting (reporting bias) | Unclear risk | No protocol available. All outcomes listed in methods were reported in the results. |