Benefit of Oral Feeding as Early as One Day After Elective Surgery for Colorectal Cancer: Oral Feeding on First Versus Second Postoperative Day

Abstract

The optimal timing of early oral intake after surgery has not been fully established. The objective of this study was to compare early oral intake at postoperative day 1 after resection of colorectal cancer with that of day 2 to identify the optimal timing for resumption of oral intake in such patients. Consecutive patients with colorectal cancer who underwent elective colorectal resection were separated into two groups. Sixty-two patients began a liquid diet on the first postoperative day (POD1 group) and 58 patients began on POD2 (POD2 group) and advanced to a regular diet within the next 24 hours as tolerated. As for gastrointestinal recovery, the first passage of flatus was experienced, on average, on postoperative day 3.1 ± 1.0 in the POD2 group and on day 2.3 ± 0.7 in the POD1 group. The first defecation was also significantly earlier in patients in the POD1 group than those in the POD2 group (POD 3.2 ± 1.2 versus 4.2 ± 1.4, respectively). No statistical difference was found between the two groups in terms of postoperative complications. Our results suggest that very early feeding on POD1 after colorectal resection is safe and feasible and that induced a quicker recovery of postoperative gastrointestinal movement in patients.

A systematic review of feeding practices among postoperative patients: is practice in‐line with evidenced‐based guidelines?

“…The present study aimed to investigate postoperative feeding practices among hospitalised patients. Although early oral feeding is a strategy that can contribute to improved recovery and reduced complications after surgery ( 1,5,6,(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) , it does not appear to be commonly applied in clinical practice. Of the 29 studies meeting the inclusion criteria, only 40% and 22% reported time to first feed and time to first solid feed in-line with evidenced-based recommendations, respectively.…”

“…Early oral feeding has been associated with a faster recovery of intestinal function (i.e. resolution of ileus) (5,6,9,10,19,20) , reduced morbidity (e.g. less infectious complications and improved wound healing and immunity) (5,(11)(12)(13)15,21,22) and improved quality of life (e.g.…”

Exploring the Differences Between Early and Traditional Diet Advancement in Postoperative Feeding Outcomes in Patients With an Ileostomy or Colostomy

“…Historically, colorectal surgeons have been hesitant to feed their patients immediately after surgery . Traditional postoperative practices restrict food and beverages, in theory to help reduce surgical complications, including the development of a paralytic ileus, potential aspiration pneumonia, and breakdown of the surgical anastomosis .…”

“…Historically, colorectal surgeons have been hesitant to feed their patients immediately after surgery . Traditional postoperative practices restrict food and beverages, in theory to help reduce surgical complications, including the development of a paralytic ileus, potential aspiration pneumonia, and breakdown of the surgical anastomosis . The surgical team has typically waited until the patient passes flatus or has a bowel movement and there are no signs of nausea, vomiting, or abdominal distention before allowing patients to eat by mouth .…”

Perioperative Management of Elderly Patients with Gastrointestinal Malignancies: The Contribution of Anesthesia

“…Early oral feeding after gastric oncological surgery seems feasible and safe, and should be started at the day of surgery, irrespective of the extent of the gastric resection and the type of surgery [75]. This also applies to early nutrition following colorectal resections, as results show that this practice is safe and feasible [76].…”