ABSTRACT
PURPOSE: Development of a standardized guideline and assessment tool is necessary. Therefore, the aim is to investigate the current state of enteral feeding management and to develop a basis for a standardized guideline. METHODS: From July 1, 2010 through June 30, 2011, this study was conducted retrospectively for 100 patients who had enteral feeding more than once only in the Intensive Care Unit, after General Surgery at Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. The analysis was based on the following factors; age, diagnosis, name of the operation, period of start and the end of enteral feeding, method of injection, flushing method, residual volumes of the stomach, location and the size of the tube, medication through tubing, and complications related to enteral feeding. RESULTS: The mean age of the patients was 60.5, 65 men and 35 women. There were 30 malignant tumors of the hepatobiliary system and pancreas, 8 gastric and duodenal cancer, 4 colon and rectal cancer, 11 peritonitis, hemoperitoneum, and bowel obstruction, and 47 others. The average period of performing enteral feeding was 11.7 days and the locations of enteral feeding tube were stomach 56%, jejunum 39%, duodenum 3%, and undescribed 2%. The methods of enteral feeding were as follows; continuous feeding 19%, cyclic feeding 75%, intermittent and bolus feeding 3%, respectively. Only 1% of patients were on flushing and 16% on stomach residual. The most common complication of enteral feeding was clogging of the tube (5%). CONCLUSION: Due to the lack of detailed charting related to enteral feeding, we were unable to analyze the statistics on the relevance of complication which was the primary endpoint. As a result, development of a standardized protocol on charting enteral feeding is suggested for optimal enteral nutritional support.
Subject(s)
Female , Humans , Male , Colon , Diagnosis , Duodenal Neoplasms , Duodenum , Enteral Nutrition , Flushing , Hemoperitoneum , Intensive Care Units , Jejunum , Korea , Nutritional Support , Pancreas , Peritonitis , Rectal Neoplasms , Residual Volume , Retrospective Studies , Seoul , StomachABSTRACT
It is rare to find three separate primary cancers in one individual. But, multiple primary cancers have been increasing because of improved methods of diagnosis and treatment and greater longevity of the population. We experienced a 52-year old male patient with synchronous triple primary adenocarcinomas occurring at the duodenum, right colon and sigmoid colon, who complained of abdominal pain and hematochezia for 2 months. The patient underwent pancreaticoduodenectomy, right hemicolectomy, and anterior resection, and was recovered uneventfully. After surgery, postoperative adjuvant chemotherapy (5-FU and Leucovorin) is currently being administered.
Subject(s)
Humans , Male , Middle Aged , Abdominal Pain , Adenocarcinoma , Chemotherapy, Adjuvant , Colon , Colon, Sigmoid , Diagnosis , Duodenum , Gastrointestinal Hemorrhage , Longevity , PancreaticoduodenectomyABSTRACT
There are many procedures described for the treatment of acromioclavicular seperation but there are still controversies concerning the best management of these injuries. Thirteen cases were operated on by technique of modified Phemister method and four cases by Bosworth method, Dept. of Orthopedic Surgery, Chonbuk National University Hospital from January 1980 to December 1984. The following results were obtained. The following results were obtained. 1. This injuries is more prevalent in male (76.4%) with peak incidence in the second, third and fourth decades(76.4%). 2. The most common causes of the injuries were traffic accidents and followed by falling from the height. 3. Fifteen patients were grade 3 by Allmans classification. 4. Operative method consists of modified Phemister method (76.4%) and Bosworth method (23.6%). 5. The operative procedures in Type 2 and Type 3 are good treatment of acromioclavicular seperation.