Early oral feeding after colorectal resection: a randomized controlled study

Area of Science:

• Gastroenterology
• Surgical Oncology
• Clinical Trials

Background:

• Nasogastric (NG) intubation is standard after abdominal surgery but causes discomfort and morbidity.
• Elective colorectal resections for cancer often involve postoperative NG intubation and fasting.

Purpose of the Study:

• To evaluate the safety and efficacy of early oral feeding without nasogastric (NG) decompression following elective colorectal resection.
• To compare outcomes between patients managed with and without postoperative NG tubes.

Main Methods:

• A randomized controlled trial involving 100 patients undergoing elective colorectal resection.
• Group A: NG catheter, fasting until flatus, then diet advancement. Group B: No NG tube, early clear liquids, then diet advancement.
• Endpoints included morbidity, intestinal function recovery, hospital stay, and patient well-being (SF-36).

Main Results:

• No significant difference in overall morbidity or SF-36 scores between groups.
• Fewer patients experienced vomiting in the NG catheter group (7 vs 16).
• Early oral feeding without NG tubes was feasible in 80% of patients, with 20% requiring decompression for vomiting.

Conclusions:

• Elective colorectal resection patients can safely receive early oral feeding without postoperative NG catheters.
• Abolishing routine postoperative NG intubation is a safe strategy, though some patients may require decompression due to vomiting.
• This approach did not reduce hospital stay or improve patient-reported well-being compared to traditional NG intubation.