【Purpose】The usefulness of enteral nutrition for various morbid conditions has been recognized. However, few clinical studies have investigated the validity of selection of enteral trophotherapy after operation for peritonitis. Central venous nutrition is frequently used with oral intake with the aim of replacing the increased caloric requirement in these patients even after the start of oral intake. We designed a randomized comparative trial to assess the duration of hospitalization, costs, adverse effects, and feasibility of enteral trophotherapy during the process of withdrawal from the acute stage after operation for peritonitis. 【Methods】Patients in whom oral intake is possible within 3~7 days after operation for diffuse peritonitis are considered eligible for enrollment in this study. After obtaining IC, the patients are randomly allocated to a group assigned to oral intake with total parenteral nutrition (Group TPN) and a group assigned to oral intake with enteral nutrition (Group EN). Racol is used as the enteral nutritional supplement, and oral or tubal (per tubam) administration is selected as the administration route according to individual patients' conditions. Neoparen is used as the total parenteral transfusion supplement. In both groups, the target caloric administration is 25~35kcal/kg/day, which includes the oral intake of calories. Both groups are instructed to conform to the protocol for at least 1 week. Judging from the urinary volume, etc., the use of any preparation containing at least 7.5% of carbohydrate and any preparation containing amino acid is avoided when the free water and electrolyte balances are corrected transvenously. 【Results】Until date, 15 patients each have been enrolled in Groups TPN and EN. There have been no differences between the two groups with respect to the age, operation time, or volume of blood loss. Oral intake was initiated (the day of entry) on about 5.8±1.7 (mean±SD) days after the operation in Group TPN and 6.1±1.1 days after the operation in Group EN. The APACHE II score at the time of enrollment was 13.7±4.1 in Group TPN and 12.6±4.6 in Group EN. The target caloric administration and the protocol could be adhered to in all the patients, except that 1 patient from Group TPN had to be withdrawn because of catheter infection. There have been no differences between the groups in regard to indices such as the serum levels of albumin, retinol-binding protein, urinary level of 3-methylhistidine, urinary creatinine, ω3/ω6 ratio, cholesterol, TG, or free fatty acid. As adverse events, abdominal symptoms were observed in 5 and 4 patients, respectively, of Groups TPN and EN, and infectious complications were observed in 6 patients of Group TPN alone. Although the difference between the two groups was not statistically significant, the oral intake tended to be higher in Group EN. The medical costs per day have been lower in Group EN. 【Discussion and Conclusion】 The results of our present study indicate the safety and usefulness of enteral nutrition during the process of introduction of oral intake after operation for peritoniti
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