Early oral feeding after colorectal resection: a randomized controlled study

Abstract

Patients undergoing elective colorectal resection can be managed without postoperative NG catheters, starting oral feeding on the first postoperative day. Albeit, no reduction in postoperative hospital stay or patients' well being could be detected, abolition of postoperative NG intubation with early oral feeding was a safe approach, with only 20% of patients requiring NG decompression because of repeated episodes of vomiting.

Enteral versus Parenteral Nutrition after Gastrointestinal Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials in the English Literature

“…11 From this point of view, many recent clinical studies, 12-14 reviews, 15,16 meta-analyses, [17][18][19][20][21][22][23] and guidelines [24][25][26] strongly recommended the use of EN compared with PN in the critically ill and surgical patients because of a lower infection rate or shorter duration of hospital stay with accompanying cost savings. Some randomized controlled trials (RCTs), [27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] on the other hand, failed to demonstrate that there was statistical benefit to EN. The mechanisms explaining this benefit of EN over PN remain unknown.…”

Comparison of fast track protocol and standard care in patients undergoing elective open colorectal resection: a meta-analysis update

“…Our findings indicate that FTP leads to a significantly faster recovery of gastrointestinal function, as indicated by time to first flatus, defecation and initiation of a soft-diet with no increase in vomiting or other morbidity. This may be partly explained by the fact that preoperative oral carbohydrate and early postoperative oral nutrition can alleviate intestinal barrier dysfunction and decrease incidence of bacterial translocation (Feo et al, 2004;Hou et al, 2010;Lewis, Egger, Sylvester, & Thomas, 2001). Studies of radiology and electrophysiology predicated a return of small bowel function in 4 to 8 hours post incision, right colon function by 24 hours, and left colon function by 72 hours.…”

Early Enteral Nutrition Within 24 h of Intestinal Surgery Versus Later Commencement of Feeding: A Systematic Review and Meta-analysis

“…19 Fourthly, we draw attention to a number of studies that appear to us to meet your inclusion criteria that have been omitted from your analysis. The study by Feo et al 20 was excluded in all your meta-analyses 1-3 as you state "both treatment groups were allowed liquid diet, therefore [there was] not control group to early feeding." 2 The cited paper, however, clearly states liquid diet in the NBM group was only provided after passage of flatus, 20 thereby meeting your inclusion criteria.…”