Randomized clinical trial of the impact of early enteral feeding on postoperative ileus and recovery

• Published in: British journal of surgery Vol. 94; no. 5; pp. 555 - 561
• Main Authors: Han-Geurts, I. J. M., Hop, W. C. J., Kok, N. F. M., Lim, A., Brouwer, K. J., Jeekel, J.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01-05-2007; Wiley
• Subjects: Adult; Aged; Aortic Aneurysm - surgery; Biological and medical sciences; Colorectal Surgery - methods; Enteral Nutrition - methods; Female; General aspects; Humans; Ileus - prevention & control; Intubation, Gastrointestinal - methods; Male; Medical sciences; Middle Aged; Pain; Pain Measurement; Postoperative Care - methods; Postoperative Complications - prevention & control; Quality of Life; Recovery of Function; Medicine; Drug; Postoperative; Treatment; Surgery; Clinical trial; Early; Recovery; Feeding
• ISSN: 0007-1323; 1365-2168
• DOI: 10.1002/bjs.5753

Background:
Postoperative convalescence is mainly determined by the extent and duration of postoperative ileus. This randomized clinical trial evaluated the effects of early oral feeding on functional gastrointestinal recovery and quality of life.
Methods:
One hundred and twenty‐eight patients undergoing elective open colorectal or abdominal vascular surgery participated in the trial. Of these, 67 were randomized to a conventional return to diet, and 61 to a regimen allowing resumption of an oral diet as soon as tolerated (free diet group).
Results:
Reinsertion of a nasogastric tube was necessary in 20 per cent of the free diet group and 10 per cent of the conventional group (P = 0·213). The complication rate was similar for both groups, as was return of gastrointestinal function. A normal diet was tolerated after a median of 2 days in the free diet group compared with 5 days in the conventional group (P < 0·001). Quality of life scores were similar in both groups.
Conclusion:
Early resumption of oral intake does not diminish the duration of postoperative ileus or lead to a significantly increased rate of nasogastric tube reinsertion. Tolerance of oral diet is not influenced by gastrointestinal functional recovery. As there is no reason to withhold oral intake following open colorectal or abdominal vascular surgery, postoperative management should include early resumption of diet. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Do not withhold oral intake