THE OUTCOMES OF EARLY ORAL FEEDING VERSUS DELAYED ORAL FEEDING AFTER COLONIC ANASTOMOSIS

Fasting following abdominal surgery is a traditional surgical practice based on fears of causing postoperative complications if oral intake begins before bowel function returns. However, supporting scientific evidence for this traditional practice is lacking and there are potential benefits from early postoperative of oral intake compared with parenteral nutrition. The aim of this study was to assess the safety, tolerability, and outcome of early oral feeding after elective colon anastomosis.

All patients who underwent elective colon anastomosis between 2009 – 2011were randomized to one of the following two groups: Group one: early oral feeding, patients received a clear liquid diet on the first postoperative day followed by a regular diet. Group two: feeding (delay) only after the resolution of their postoperative ileus. The patients were monitored for vomiting, bowel movements, time of regular diet consumption, complications, amount of serum received, and length of hospitalization.

Seventy-eight patients were studied, 38 patients in group one and 40 patients in group two. There were significant differences between the early and regular feeding groups in the overall complications and significant reduction of length of hospitalization, serum reception, postoperative ileus, vomiting, and abdominal distension, time of presence of flatus, postoperative nasogastric tube placement, morbidity, wound complications, and pneumonia in group one.

Early oral feeding is safe and can be tolerated by patients. Reduced length of ileus and shorter hospitalization may occur with multimodal protocols. Thus, it may become a routine feature of postoperative management in these patients. Further studies should focus on the cost effectiveness, patient's satisfaction, and other physiological changes.