Early feeding after oncological colorectal surgery in Japanese patients

We aimed to determine the safety and feasibility of an alternative postoper ative oral intake protocol for Japanese patients who had had oncological co lorectal surgery, with the goal of shortening the length of postoperative s tay to the same level as that in Western countries. The subjects of the stu dy were 42 consecutive patients who underwent elective oncological colorect al surgery. Two protocols, Japanese traditional management (TM; n = 20) and alternative management (AM; n = 22), were employed. The two protocols diff ered in their management of oral intake after surgery. Tolerance of the alt ernative protocol and the incidence of postoperative complications were det ermined. The mean length of postoperative stay in the AM and TM groups was 11.5 +/- 1.2 and 24.0 +/- 2.1 days, respectively (P < 0.0001; t-test). Anal ysis of the patients who underwent open operation also revealed that the le ngth of postoperative stay was less in the AM group than in the TM group (1 2.3 +/- 1.7 and 24.7 +/- 2.2 days, respectively, P = 0.0003). One patient i n the TM group developed small bowel obstruction during the introduction of oral intake. One patient in the AM group also developed small bowel obstru ction, after discharge, and was readmitted. Other patients tolerated both t he TM and AM protocols. Morbidity in the AM group was 20.0%, and that in th e TM group was 30.0% (P = 0.72). The employment of an alternative postopera tive oral intake protocol was safe and feasible for Japanese patients. Furt her investigation is needed to determine the possible benefits, both medica l and socioeconomic, of this approach.