title: The effect of cisapride on the success of early feeding after elective open colon resection.
abstract: Early postoperative feeding after open colon resection has been shown to be safe and effective. However, approximately 13 per cent of patients fail to tolerate it. We hypothesized that the use of promotility agents may decrease failure of early postoperative feeding after elective open colectomy. As part of a consecutive case series metoclopramide or cisapride was administered to patients undergoing open colectomy as part of an early feeding protocol. The early feeding protocol consisted of instituting a clear liquid diet on postoperative day (POD) 2, followed by a regular diet on POD 3. One hundred fifty-one patients received early-feeding without promotility agents (Group I). The next 49 patients were treated with metoclopramide (Group II), and 31 patients received cisapride (Group III). In Group I 20 of 151 patients (13.2%) failed early feeding, and the mean hospital stay was 3.77 days (range 3-11 days). In Group II seven of 49 patients (14.2%) failed early postoperative feeding, and the mean hospital stay was 3.67 days (range 3-8 days). Group III had no patients who failed to tolerate early feeding, and the mean hospital stay was 3.32 days (range 3-5 days). There were no anastomotic leaks or abdominal abscesses in any group. No cardiac arrhythmias were associated with cisapride. A decrease in early feeding failure was observed with cisapride, administration.
authors.affiliation: Department of Surgery, Kaiser Permanente Medical Center, Los Angeles, California 90027, USA.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Camberos
authors.forename: Judith
authors.initials: J
authors.lastname: Cymerman
authors.forename: L Andrew
authors.initials: LA
authors.lastname: DiFronzo
authors.forename: Theodore X
authors.initials: TX
authors.lastname: O'Connell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000932:Antiemetics / Q000008:administration & dosage; D020117:Cisapride / Q000008:administration & dosage*; D003082:Colectomy / Q000009:adverse effects; D017558:Elective Surgical Procedures; D004750:Enteral Nutrition / Q000009:adverse effects; D005260:Female; D005765:Gastrointestinal Agents / Q000008:administration & dosage; D005769:Gastrointestinal Motility / Q000187:drug effects*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage; D008875:Middle Aged; D011184:Postoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000932:Antiemetics; D005765:Gastrointestinal Agents; D008787:Metoclopramide; D020117:Cisapride