الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
GI tract surgery has numerous causes, and the goal is to wean infants off parenteral nourishment and establish them on enteral feeds. After surgery, neonates may lose bodily resources due to poor nutrition intake and lengthy fasting. NPO/nil by mouth is the most prevalent post-operative procedure. Misplaced concern of aspiration, nausea, vomiting, and anastomotic problems led to frequent ”NPO” prescription.
Postoperative fasting lasts 0–5 days, depending on the procedure. The impacts of fasting include extended stay, higher usage of parenteral nourishment, social repercussions, and significant health system expenses.
Starvation causes villi shrinkage, disaccharide activity decline, intestinal mucosa mass decrease, and enterocyte DNA loss. This dysfunctional enterocyte increases intestinal mucosa antigen and macromolecule permeability. The lack of normal colonic flora reduces Vitamin K synthesis in starvation-induced gut mucosal damage. This reduces growth factors and bile acid metabolism. Starved gut and aberrant colonic bacterial environment cause pathological bacteria colonization and sepsis and sequelae. Starvation also reduces gut-associated lymphoid tissue immune cells. This reduced gut immunity increases toxin absorption and decreases foreign antigen response. This causes bacterial translocation.
Cochrane studies support early enteral feeding and little benefit in keeping patients “nil by mouth” after gastrointestinal surgery.
The aim of our study was to evaluate the effect of early vs late enteral feeding after abdominal surgery on neonatal outcome after surgery, weight gain, and length of hospital stay, time to reach full enteral feeding, time to pass first stool, surgical site infections, and sepsis and electrolyte disturbances.
This randomized controlled study was conducted at Assiut University Children Hospital in the period from the 1st of January 2022 up to the end of December 2022. The study included 86 neonates who were undergoing abdominal surgery.
The study included 2 groups:
group A: start enteral feeding within 2 days postoperative
group B: start enteral feeding after 2 days postoperative according to clinician discretion based on clinical progress.