Safe and effective early postoperative feeding and hospital discharge after open colon resection

Recent articles have stressed early postoperative feeding and hospital discharge as major benefits of laparoscopic colon surgery. From March 1993 to December 1994, an early feeding protocol after open colon resection consisting of clear liquid diet on postoperative Day (POD) 2, then advancing to regular diet on POD 3, and discharging home as tolerated was applied to 41 patients (Group A). We reviewed the charts of 41 consecutive patients from January 1992 to February 1993 who were operated immediately before the protocol and whose diet was started by traditional methods (Group B). Both groups were similar in age and types of procedures performed. Clear liquid diet was started earlier in Group A than Group B (all patients on POD 2 versus average POD 4.9 (range, 4-7 days), but it was tolerated by a similar number of patients in both groups (90% versus 85%). The mortality and morbidity in both Groups were similar. In Group B, four patients (9.8%) did not tolerate diet and needed nasogastric tube, whereas none required nasogastric tube in Group A. The average hospital stay was 4.2 days (range, 3-8 days) in group A versus 6.7 days (range, 5-34 days) in Group B. In Group A, 67 per cent were discharged home by POD 4 versus none in Group B. Neither group had readmission within 2 weeks for recurrent nausea or vomiting. The early postoperative feeding and hospital discharge are safe and effective after open colon surgery.