Abstract
Background: Previous studies have shown that early postoperative oral feeding is feasible. Traditionally patients were fed when flatus or defecation documented the return of bowel function. This study was undertaken to determine factors that may preclude early feeding.
Methods: One hundred four successive patients underwent colorectal surgery from October 1999 to January 2001. Eighty-nine patients started an oral diet either on postoperative day 1 or 2. Their clinical outcomes were recorded prospectively. Fifteen of the 104 patients were excluded for small-bowel resection 5 patients, perioperative complications 5 patients, prior radiation 3 patients, and small-bowel obstruction 2 patients. A failure in postoperative feeding consisted of nausea, vomiting, or readmission.
Results: The mean age of our cohort was 65 years range, 28–87 years. There were 45 male and 44 female patients. The mean postoperative hospital stay was 6 days range, 3–13 days. The median American Society of Anesthesiology score was II range, I–IV. The types of resection performed were right colectomy 27 patients, low anterior resection 26 patients, sigmoid resection 11 patients, abdominoperineal resection 8 patients, formation or closure of colostomy 7 patients, posterior pelvic exenteration 4 patients, total colectomy 3 patients, left colectomy 2 patients, and transverse colectomy 1 patient. Sixty-five patients 73% tolerated early oral feeding. Of the 24 patients that did not, 16 had nausea or emesis, and 8 required readmission for postoperative complications small-bowel obstruction [4 patients], wound dehiscence [1 patient], abdominal pain [1 patient], and anastomotic leak [2 patients]. Univariate analysis revealed that the use of volume expanders contributed to intolerance of early feeding. On multivariate analysis, blood loss during the operation was the only factor contributing to failure of early postoperative oral feeding.
Conclusions: Early oral feeding is safe and feasible for postcolectomy patients with a history of colorectal neoplasms.
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Presented in part at the 54th Annual Cancer Symposium of the Society of Surgical Oncology, Washington, DC, March 15–18, 2001.
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Petrelli, N.J., Cheng, C., Driscoll, D. et al. Early Postoperative Oral Feeding After Colectomy: An Analysis of Factors That May Predict Failure. Ann Surg Oncol 8, 796–800 (2001). https://doi.org/10.1007/s10434-001-0796-8
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DOI: https://doi.org/10.1007/s10434-001-0796-8