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Practice Changes in Postoperative Feeding after Elective Colorectal Surgery: From Prospective Randomized Study to
Ino Chough1, Karen Zaghiyan, Gayane Ovsepyan
1Division of Colorectal Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
The American Surgeon
|February 13, 2019
Summary
Early postoperative feeding after colorectal surgery improves outcomes. While colorectal surgeons adopted early feeding, general surgeons remain hesitant, despite evidence of faster recovery and shorter hospital stays.
Area of Science:
- Colorectal Surgery
- Surgical Nutrition
- Gastroenterology
Background:
- Early postoperative feeding is standard after colorectal surgery, enhancing recovery.
- A prior study showed solid diets on postoperative day (POD) 1 improved bowel function and reduced hospital stays without increasing morbidity.
Purpose of the Study:
- To assess the impact of early feeding evidence on diet advancement practices by general surgeons (GS) and colorectal surgeons (CRS).
- To compare current practices with a 2012 cohort undergoing elective colorectal surgery.
Main Methods:
- Prospective evaluation of patients undergoing elective colorectal surgery.
- Comparison of diet advancement practices between current and historical cohorts (2012).
- Analysis of feeding practices based on surgeon specialty (GS vs. CRS).
Main Results:
- Early feeding on POD 0 and POD 1 significantly increased in the recent cohort.
- CRS significantly increased early feeding on POD 0 (0% vs. 83%), while GS did not (13% vs. 13%).
- No significant difference in POD 1 feeding between time periods for either specialty.
Conclusions:
- Colorectal surgeons have largely adopted early postoperative feeding, particularly on POD 0.
- General surgeons show reluctance in advancing diets early post-colorectal surgery, despite established benefits.
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