MUST EARLY POSTOPERATIVE ORAL INTAKE BE LIMITED TO LAPAROSCOPY

PURPOSE: This prospective, randomized study was designed to evaluate w hether or not early postoperative feeding (claimed as a unique benefit of laparoscopic surgery) is possible after laparotomy and colorectal resection. METHODS: The trial was performed between July 1, 1992 and O ctober 31, 1992 and included all 64 consecutive patients who underwent laparotomy with either a colonic or an ileal resection. In all cases the nasogastric tube was removed immediately after the operation. Grou p 1 consisted of 32 patients (age range, 15-81 years; mean, 52 years) who received a regular diet on the first postoperative morning. Group 2 consisted of 32 patients (age range, 15-87 years; mean, 52 years) wh o were fed in a traditional manner. Regular food was permitted after r esolution of ileus as defined by resumption of bowel movements in the absence of abdominal distention, nausea, or vomiting. RESULTS: The rat e of nasogastric tube reinsertion for distention with persistent vomit ing was 18.7 percent (six patients) in Group 1 and 12.5 percent (four patients) in Group 2. Although vomiting was experienced more frequentl y by patients in Group 1 (44 percent vs. 25 percent, respectively), th ere was no difference between the two groups with regard to the durati on of postoperative ileus (3.6 vs. 3.4 days, respectively). In the 26 patients from Group 1 who did not require nasogastric tube reinsertion , there was a trend toward shorter hospitalization (6.7 vs. 8.0 days, respectively). CONCLUSION: Early oral intake is possible after laparot omy and colorectal resection. Thus, the laparoscopic surgeon's claim o f early tolerated oral intake may not be unique to laparoscopy.