Comparison of Outcome in Early Vs Conventional Feeding after Colostomy Closure in Paediatric Population

Abstract

Background: The traditional practice of delaying enteral feeding after pediatric colostomy closure has been a subject of reconsideration in the wake of emerging evidence suggesting the benefits of early enteral nutrition. The hypothesis driving this shift stems from the understanding that early feeding may enhance recovery by improving gut function and reducing hospital stay, which is particularly significant in the pediatric population where rapid return to normal activities and minimizing hospital-associated stress are crucial.
 Objective: This study aimed to compare the outcomes of early enteral feeding versus conventional feeding protocols post-colostomy closure in pediatric patients, focusing on parameters such as the incidence of postoperative complications, the duration of hospital stay, and overall recovery.
 Methods: Conducted as a randomized controlled trial at the Department of Pediatric Surgery, Children Hospital, Lahore, this study enrolled 70 pediatric patients, evenly divided into two groups: early enteral feeding (Group A) and conventional feeding (Group B). Both groups were meticulously matched for age, weight, and gender to ensure comparability. The study meticulously recorded and analyzed postoperative outcomes including anastomotic leakage, vomiting, upper respiratory tract infections (URTI), wound infections, and other complications using chi-square and t-tests for statistical significance.
 Results: The mean age of patients was 6.67 ± 3.42 years, with a balanced distribution between the groups (p = 0.917). In Group A, 8.6% experienced anastomotic leakage compared to 11.4% in Group B; vomiting occurred in 11.4% of Group A and 8.6% of Group B; URTI was noted in 2.9% of Group A versus 14.3% in Group B; wound infection rates were 8.6% for Group A and 14.3% for Group B. The average post-operative hospital stay significantly favored Group A at 4.26 ± 0.43 days versus 7.05 ± 0.32 days for Group B (p = 0.0001).
 Conclusion: Early enteral feeding after pediatric colostomy closure significantly reduces the hospital stay without increasing the risk of postoperative complications, suggesting a beneficial role in pediatric surgical recovery. This study supports the integration of early feeding protocols into postoperative care for pediatric colostomy patients, contributing to the evolving practice of pediatric surgery.