Randomized clinical trial of patient-controlled versus fixed regimen feeding after elective abdominal surgery.
BACKGROUND
Although studies have shown that early oral feeding after abdominal surgery is feasible, many surgeons still advocate a careful, slow introduction of postoperative oral feeding. This study was conducted to investigate whether patient-controlled postoperative feeding is possible in patients undergoing colonic or aortic surgery.


METHODS
A randomized clinical trial compared patient-controlled postoperative oral feeding (PC group) with a fixed regimen (FR group). Patients in the PC group (n = 56) received oral feeding when they requested it; patients in the FR group (n = 49) started a normal diet on day 5. Endpoints were time to tolerance of a diet similar to the preoperative diet, reinsertion of a nasogastric tube, complications and duration of hospitalization.


RESULTS
Median time to resumption of a normal diet was 3 days in the PC group and 5 days in the FR group (P < 0.001). Reinsertion of a nasogastric tube was required in nine patients in each group (P not significant). The incidence of complications was similar in both groups: 12 of 56 in the PC group and 13 of 49 in the FR group. There was no significant difference in duration of hospital stay between the groups.


CONCLUSIONS
Most patients tolerate a normal diet on the third day after operation. Patient-controlled postoperative feeding is safe and leads to earlier resumption of a normal diet.
Han-Geurts
I J
IJ
Department of Surgery, Erasmus University Medical Centre, Rotterdam, The Netherlands. Capel@hlkd.azr.nl
Jeekel
J
J
Tilanus
H W
HW
Brouwer
K J
KJ
D000368:Aged; D001018:Aortic Diseases / Q000601:surgery; D003108:Colonic Diseases / Q000601:surgery; D017558:Elective Surgical Procedures; D005248:Feeding Methods; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D009752:Nutritional Status; D011182:Postoperative Care / Q000379:methods*; D011446:Prospective Studies