Early oral nutrition after major upper gastrointestinal surgery: why not?
OBJECTIVE
To examine the available documentation addressing the introduction of early food after major upper gastrointestinal surgery.


RESULTS
No high-quality trials, recent or old, have addressed this topic. A few attempts have been identified. Information is extracted from papers discussing other topics of postoperative care in this field. Generally, nasogastric tubes and nil-by-mouth prevail in the early postoperative period.


CONCLUSIONS
The reluctance to allow early food at will is not evidence based, but neither is the safety of an alternative regimen. Early food at will should probably be allowed after hepatic resections, gastric resections, and total gastrectomies and maybe also after pancreaticoduodenectomies. Resections of the esophagus remain the most challenging issue. The need is urgent for high-powered and high-quality randomized controlled clinical trials.
Lassen
Kristoffer
K
Department of Digestive Surgery, University Hospital Northern Norway, Tromsø, Norway. lassen@unn.no
Revhaug
Arthur
A
D004750:Enteral Nutrition; D005767:Gastrointestinal Diseases / Q000601:surgery* / Q000628:therapy*; D041981:Gastrointestinal Tract / Q000601:surgery; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods; D011182:Postoperative Care / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome