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Updated: Sep 27, 2026

An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
[Early feeding after intestinal anastomoses: risks or benefits?]
José Eduardo de Aguilar-Nascimento1, Júlio Göelzer
1Departamento de Cirurgia, Faculdade de Ciências Médicas, Universidade Federal de Mato Grosso, Brasil. aguilar@zaz.com.br
Insights
Early oral feeding after intestinal anastomoses is safe and speeds up the return of bowel function. This approach reduces the time to pass flatus without increasing complications like anastomotic dehiscence.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Postoperative Care
Background:
- Traditionally, oral intake post-intestinal anastomosis is delayed until ileus resolves.
- This practice aims to prevent complications associated with early feeding.
Purpose of the Study:
- To evaluate the safety and efficacy of early oral feeding after intestinal anastomoses.
- To compare postoperative outcomes between early and conventional feeding protocols.
Main Methods:
- 43 patients undergoing intestinal anastomoses were randomized into two groups: early feeding (oral intake at 24h) and conventional feeding (after ileus resolution).
- Groups were matched for key demographic and surgical variables.
Main Results:
- Early feeding significantly reduced the time to passage of flatus (35 vs. 44 hours).
- No significant differences were observed in morbidity, mortality, or anastomotic dehiscence rates between groups.
- Vomiting requiring nasogastric decompression occurred in 13% of the early group and 10% of the conventional group.
Conclusions:
- Initiating oral feeding on the first postoperative day after intestinal anastomoses is safe.
- Early feeding accelerates the resolution of postoperative ileus without compromising anastomotic integrity or increasing morbidity.
Background:
Oral intake after intestinal anastomoses has traditionally been prescribed only after the resolution of ileus. The aim of this study was to evaluate the immediate results of early oral feeding in postoperative course of intestinal anastomoses.
Methods:
43 consecutive patients submitted to operations associated with intestinal anastomoses were randomized to two groups: early group (N=23) allowed to oral intake after 24 h of operation and conventional group (N=20) in which feeding was allowed only after the ileus resolution. Groups were statistically similar for age, gender, nutritional status, duration of operation, local and type of anastomoses, type of anesthesia and use of morphine.
Results:
Three (13%) patients of early group and two (10%) of conventional presented vomiting requiring nasogastric decompression (P.0.05). Three (7.3%) patients, two (10%) in early feeding group and one (5%) in conventional group died (P>0.05). There was no difference between the groups for morbidity. Two anastomotic dehiscences occurred in each group. Passage of flatus was reported earlier (P=0.01) in early feeding group (35 +/- 13 h) when compared with conventional group (44 +/- 12 h). Hospital stay was similar between the two groups (conventional group = 12 [6-36] days versus early feeding group = 10 [5-29] days).
Conclusions:
The return of oral feeding on the first postoperative day in patients submitted to intestinal anastomoses is safe, not associated with the occurrence of anastomotic dehiscence and moreover, related to a shorter resolution of ileus.
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