EARLY FEEDING AFTER ELECTIVE OPEN COLORECTAL RESECTIONS - A PROSPECTIVE RANDOMIZED TRIAL

Background: A period of starvation after colorectal resections to allo w for resolution of the clinical evidence of ileus has been an unchall enged surgical doctrine until recent times. A prospective randomized t rial comparing early feeding to traditional management in patients und ergoing open elective colorectal resections is reported. Methods: Pati ents undergoing elective intraperitoneal colorectal resections without stoma formation were randomized to either an early feeding or control group. The early feeding group were allowed free fluids from 4 h post operatively progressing to a solid diet from the first postoperative d ay as they tolerated it. The control group remained nil orally until p assage of flatus or bowel motion and were then commenced on fluids pro gressing to solids over 24-48 h. Results: There were 40 patients in ea ch group well matched for age, sex, type and duration of operation, me thod of analgesia and mobilization. Thirty-two patients (80%) in the e arly feeding group tolerated a diet within 48 h. There was no signific ant difference in the rate of vomiting, nasogastric reinsertion or com plications. The early feeding group tolerated a diet, passed flatus, u sed their bowels, and were discharged from hospital significantly earl ier than the control group. Conclusion: Early feeding after elective o pen colorectal resections is successfully tolerated by the majority of patients, leading to earlier resolution of ileus and hospital dischar ge.