Early oral feeding after colorectal resection: a randomized controlled study.
BACKGROUND
Nasogastric (NG) intubation is widely used following elective abdominal operations although it is associated with morbidity and discomfort. The present study is a randomised controlled trial on the effect of early oral feeding without NG decompression following elective colorectal resection for cancer.


METHODS
One hundred patients were randomized to group A (NG catheter and fasting until passage of flatus, followed by liquid diet advanced to soft-solid) or group B (no NG tube, clear liquids the day after surgery, followed by soft-solid food). The endpoints were: (i) morbidity; (ii) resumption of intestinal function; (iii) length of hospital stay; and (iv) patients' well being evaluated by short-form health survey [36 items] (SF-36).


RESULTS
Twelve complications occurred in group A (50 patients) and 13 in group B (50 patients) (P = NS). Seven patients developed vomiting in group A as compared to 16 in group B (P < 0.05). Twenty per cent of patients required NG decompression in group B hence 80% did not need NG tubes. Resumption of intestinal function occurred after 4 days, and length of hospital stay was 7 days in both groups. No significant difference was detected between groups (P = NS) in the SF-36 score change before and after the operation.


CONCLUSIONS
Patients undergoing elective colorectal resection can be managed without postoperative NG catheters, starting oral feeding on the first postoperative day. Albeit, no reduction in postoperative hospital stay or patients' well being could be detected, abolition of postoperative NG intubation with early oral feeding was a safe approach, with only 20% of patients requiring NG decompression because of repeated episodes of vomiting.
Feo
Carlo V
CV
Section of General Surgery, Department of Surgery, School of Medicine, University of Ferrara, Ferrara, Italy. cvfeo@unife.it
Romanini
Barbara
B
Sortini
Davide
D
Ragazzi
Riccardo
R
Zamboni
Paolo
P
Pansini
Gian C
GC
Liboni
Alberto
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000601:surgery*; D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005414:Flatulence; D006801:Humans; D007441:Intubation, Gastrointestinal; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D018709:Statistics, Nonparametric; D016896:Treatment Outcome