title: A prospective single-institution evaluation of current practices of early postoperative feeding after elective intestinal surgery.
abstract: Postoperative diet advancement in patients undergoing elective small bowel or colorectal surgery by general surgeons (GSs) and colorectal surgeons (CRSs) was prospectively evaluated. Demographic (age and gender), disease location (small bowel or colorectum), surgical approach (laparoscopic or open), and surgeon characteristics (GS or GRS) were tabulated. Postoperative feeding after surgery on postoperative Day (POD) 1 was assessed. Operations involved the colorectum (n=43 [72%]) or small bowel (n=17 [28%]) and were performed using laparoscopy (n=38 [63%]) or open (n=22 [37%]) techniques. Operations were performed by GSs (n=30) or CRSs (n=30). Early feeding was ordered on POD 1 on 34 patients (57%). The remaining 26 patients (43%) were kept nothing by mouth. Factors associated with early feeding included age younger than 50 years (P=.004), surgery done by CRSs (P<0.0001), operations on the colorectum (P=0.04), and laparoscopic surgery (P=0.07). Multivariable analysis revealed that age younger than 50 years (odds ratio [OR], 9.5; 95% confidence interval [CI], 1.8 to 52; P=0.01), surgery done by CRSs (OR, 16.3; 95% CI, 3.4 to 79.6; P=0.001), and use of laparoscopic surgery (OR, 12; 95% CI, 2.1 to 67; P=0.007) were associated with early postoperative feeding. Early postoperative feeding does not appear to be applied commonly in clinical practice. Younger patient age, surgery done by CRSs, and laparoscopy are associated with the use of early postoperative feeding after elective intestinal surgery.
authors.affiliation: Division of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
authors.forename: Tamar
authors.initials: T
authors.lastname: Rohatiner
authors.forename: Joseph
authors.initials: J
authors.lastname: Wend
authors.forename: Samuel
authors.initials: S
authors.lastname: Rhodes
authors.forename: Zuri
authors.initials: Z
authors.lastname: Murrell
authors.forename: Dror
authors.initials: D
authors.lastname: Berel
authors.forename: Phillip
authors.initials: P
authors.lastname: Fleshner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003107:Colorectal Surgery; D017558:Elective Surgical Procedures; D004750:Enteral Nutrition; D005260:Female; D013502:General Surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D013997:Time Factors; D055815:Young Adult