A simplified rehabilitation program for patients undergoing elective colonic surgery--randomized controlled clinical trial.
BACKGROUND
We have proposed a simplified perioperative rehabilitation program for elective colonic surgery that is focused on early oral nutrition and that could reduce hospital stay and postoperative ileus time without raising complications and readmission rates.


METHODS
Fifty-four patients admitted for elective colonic surgery were prospectively randomized into two groups: (1) an early feeding group (EFG)-on the first postoperative day, patients initially received a oral liquid diet and were advanced to a regular diet within the next 24 h as tolerated and at their discretion; (2) a traditional care group-patients were managed by nothing per orus until the elimination of the first flatus and then submitted to an oral liquid diet, followed by a regular diet within the next 24 h as described for the EFG. All patients followed a well-defined, simplified rehabilitation program.


RESULTS
Patients' baseline characteristics were similar in the two groups. Hospital stay was significantly lower in the EFG (4.0 [±3.7] versus 7.6 [±8.1] days; p = 0.000). Diet tolerance and progression were similar between groups. Time to first flatus after surgery was significantly lower in the EFG (1.5 [±0.5] versus 2.0 [±0.7] days; p = 0.019). Complication and readmission rates were similar in both groups.


CONCLUSIONS
Early oral nutrition associated with a simplified perioperative rehabilitation program reduces postoperative length of hospital stay and ileus time after elective colonic resection without increasing rates of complications or readmissions.
Division of Colorectal Surgery, Instituto Alfa de Gastroenterologia/Hospital das Clínicas, School of Medicine, Universidade Federal de Minas Gerais, Av. Alfredo Balena, 110-2º andar, CEP 30130-100, Belo Horizonte, Minas Gerais, Brazil. leonardomacielfonseca@gmail.com
Leonardo Maciel
LM
da Fonseca
Magda Maria
MM
Profeta da Luz
Antônio
A
Lacerda-Filho
Maria Isabel Toulson Davisson
MI
Correia
Rodrigo
R
Gomes da Silva
D003106:Colon / Q000601:surgery*; D004032:Diet; D013505:Digestive System Surgical Procedures / Q000401:mortality / Q000534:rehabilitation*; D017558:Elective Surgical Procedures / Q000401:mortality / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000534:rehabilitation