BACKGROUND:Postoperative convalescence is mainly determined by the extent and duration of postoperative ileus. This randomized clinical trial evaluated the effects of early oral feeding on functional gastrointestinal recovery and quality of life. METHODS:One hundred and twenty-eight patients undergoing elective open colorectal or abdominal vascular surgery participated in the trial. Of these, 67 were randomized to a conventional return to diet, and 61 to a regimen allowing resumption of an oral diet as soon as tolerated (free diet group). RESULTS: Reinsertion of a nasogastric tube was necessary in 20 per cent of the free diet group and 10 per cent of the conventional group (P = 0.213). The complication rate was similar for both groups, as was return of gastrointestinal function. A normal diet was tolerated after a median of 2 days in the free diet group compared with 5 days in the conventional group (P < 0.001). Quality of life scores were similar in both groups. CONCLUSION: Early resumption of oral intake does not diminish the duration of postoperative ileus or lead to a significantly increased rate of nasogastric tube reinsertion. Tolerance of oral diet is not influenced by gastrointestinal functional recovery. As there is no reason to withhold oral intake following open colorectal or abdominal vascular surgery, postoperative management should include early resumption of diet.
RCT Entities:
BACKGROUND: Postoperative convalescence is mainly determined by the extent and duration of postoperative ileus. This randomized clinical trial evaluated the effects of early oral feeding on functional gastrointestinal recovery and quality of life. METHODS: One hundred and twenty-eight patients undergoing elective open colorectal or abdominal vascular surgery participated in the trial. Of these, 67 were randomized to a conventional return to diet, and 61 to a regimen allowing resumption of an oral diet as soon as tolerated (free diet group). RESULTS: Reinsertion of a nasogastric tube was necessary in 20 per cent of the free diet group and 10 per cent of the conventional group (P = 0.213). The complication rate was similar for both groups, as was return of gastrointestinal function. A normal diet was tolerated after a median of 2 days in the free diet group compared with 5 days in the conventional group (P < 0.001). Quality of life scores were similar in both groups. CONCLUSION: Early resumption of oral intake does not diminish the duration of postoperative ileus or lead to a significantly increased rate of nasogastric tube reinsertion. Tolerance of oral diet is not influenced by gastrointestinal functional recovery. As there is no reason to withhold oral intake following open colorectal or abdominal vascular surgery, postoperative management should include early resumption of diet.
Authors: Jerry T Dang; Vivian G Szeto; Ahmad Elnahas; James Ellsmere; Allan Okrainec; Amy Neville; Samaad Malik; Ekua Yorke; Dennis Hong; Laurent Biertho; Timothy Jackson; Shahzeer Karmali Journal: Surg Endosc Date: 2019-06-17 Impact factor: 4.584
Authors: Joseph C Carmichael; Deborah S Keller; Gabriele Baldini; Liliana Bordeianou; Eric Weiss; Lawrence Lee; Marylise Boutros; James McClane; Scott R Steele; Liane S Feldman Journal: Surg Endosc Date: 2017-08-03 Impact factor: 4.584
Authors: U O Gustafsson; M J Scott; W Schwenk; N Demartines; D Roulin; N Francis; C E McNaught; J Macfie; A S Liberman; M Soop; A Hill; R H Kennedy; D N Lobo; K Fearon; O Ljungqvist Journal: World J Surg Date: 2013-02 Impact factor: 3.352
Authors: Sadeesh K Srinathan; Tamara Hamin; Stephen Walter; A Lawrence Tan; Helmut W Unruh; Gordon Guyatt Journal: Can J Surg Date: 2013-12 Impact factor: 2.089
Authors: Helge Bruns; Nuh N Rahbari; Thorsten Löffler; Markus K Diener; Christoph M Seiler; Matthias Glanemann; Giovanni Butturini; Christoph Schuhmacher; Inga Rossion; Markus W Büchler; Tido Junghans Journal: Trials Date: 2009-07-26 Impact factor: 2.279