EARLY POSTOPERATIVE FEEDING AFTER ELECTIVE COLORECTAL SURGERY

Background: Several investigators have demonstrated that routine nasog astric decompression after abdominal surgery is unnecessary and can be safely eliminated, and 1 recent study demonstrated the safety of earl y oral feedings. Objective: To test the hypothesis that successful ear ly feeding would lead to a shorter duration of hospitalization and, th erefore, would be more cost-effective. Patients: Fifty-eight patients with elective colorectal surgery. Methods: Patients were prospectively randomized to 1 of 2 postoperative treatment arms: early feeding (EF group, n=29) and traditional feeding (TF group, n=29). All patients in the EF group began a liquid diet on the first postoperative day and w ere advanced to a regular diet when they consumed 1000 mt in 24 hours. All patients in the TF group began a liquid diet after resolution of the postoperative ileus and were advanced to a regular diet after cons uming 1000 mt in 24 hours. Patients were dismissed after tolerating tw o thirds of the regular diet. Both groups had intraoperative,orogastri c tubes that were removed at the end of surgery. Nasogastric tubes wer e inserted for persistent postoperative vomiting. Results: No signific ant differences were noted in age, types of procedures, or in prior ab dominal surgery in either group. No significant differences were seen in rates of nausea (55% in EF vs 50% in TF group) or vomiting (48% in EF vs 33% in TF group). One patient in the EF group had aspiration pne umonia, and anastomotic leak resulted in sepsis and eventual death of 1 patient in the TF group. No significant difference was observed in l ength of hospital stay between the 2 groups (mean+/-SD, 7.2+/-3.3 days in EF vs 8.1+/-2.3 days in TF group). Conclusions: Early oral feeding after elective colorectal surgery is safe. Most of the patients toler ated EF; however, there was no significant difference in duration of h ospitalization in these patients.