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- Title
Early feeding post major colonic surgery: why we should all be doing it.
- Authors
Smith, J.J; Mathur, P; Burke, C.C; Ramesh, S; Dawson, P.M
- Abstract
Aims: Gastrointestinal surgery results in increased intestinal permeability increasing morbidity and mortality. This study focuses on very early feeding post major colonic resection and how it influences outcome. Methods: Sixty-seven consecutive patients undergoing colonic resection were entered into the study. Patients in the early feeding group (43) were allowed free fluids (plus external supplements) immediately following surgery. Patients in the control group were treated in the ‘traditional’ fashion of awaiting resolution of bowel sounds and passage of flatus before free fluids were commenced. There were 30 women and 37 men aged 26–90 (median 67) years. Results: The two groups were comparable by age, sex ratio, CEPOD status and ASA grade. Patients in the ‘early’ group were tolerating free fluids at 0.65 (0–2) days compared to the ‘traditional’ group at 2.17 (1–9) days (P < 0.001). Time to ‘normal’ diet was 3.42 (0–9) days in the ‘early’ group and 5.58 (2–15) days in the ‘traditional’ group (P < 0.001). Complications included four major (including one leak, 1 MI) and three minor in the ‘early’ group and eight major (includign three leaks, 1 MI) in the ‘traditional’ group (P = 0.127). The ‘early’ group had one death from systemic sepsis, and there were two deaths from systemic sepsis in the ‘traditional’ group (P = 0.045). Time to discharge was 14 (5–44) days in the ‘early’ group and 22 (7–73) days in the late group (P = 0.006). Conclusions: Early feeding by the enteral route reduces septic complications, inpatient mortality and significantly reduces inpatient stay, all of which have significant economic benefits.
- Subjects
SURGICAL nutrition; GASTROINTESTINAL surgery
- Publication
British Journal of Surgery, 2002, Vol 89, p69
- ISSN
0007-1323
- Publication type
Article
- DOI
10.1046/j.1365-2168.89.s.1.2_6.x