Early feeding after elective open colorectal resections: a prospective randomized trial

Area of Science:

• Colorectal surgery
• Gastroenterology
• Surgical outcomes

Background:

• Traditional surgical doctrine mandates a period of starvation post-colorectal resection to manage postoperative ileus.
• Recent evidence challenges this long-standing practice, prompting re-evaluation of feeding protocols.

Purpose of the Study:

• To compare the efficacy and safety of early feeding versus traditional nil-oral management in patients undergoing elective open colorectal resections.

Main Methods:

• A prospective randomized trial involving patients undergoing elective open colorectal resections without stoma formation.
• Patients were randomized into two groups: early feeding (fluids from 4 hours, advancing to solids) and control (nil orally until flatus/bowel motion, then gradual diet advancement).

Main Results:

• 80% of patients in the early feeding group tolerated a diet within 48 hours.
• No significant differences were observed in vomiting, nasogastric reinsertion rates, or overall complications between groups.
• The early feeding group demonstrated significantly earlier tolerance of diet, passage of flatus, bowel movement, and hospital discharge.

Conclusions:

• Early feeding is well-tolerated by most patients following elective open colorectal resections.
• Implementing early feeding protocols can lead to faster resolution of postoperative ileus and reduced hospital stay.