title: Early versus traditional postoperative oral feeding in patients undergoing elective colorectal surgery: a meta-analysis of randomized clinical trials.
abstract: BACKGROUND
  The safety and effectiveness of early oral feeding after colorectal surgery has not been determined. We performed a meta-analysis to evaluate surgical outcomes following early oral feeding compared with traditional oral feeding in patients undergoing elective colorectal surgery.
  
  
  METHODS
  MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to identify randomized clinical trials comparing the outcomes following early oral feeding versus traditional oral feeding in patients undergoing elective colorectal surgery. The trials must have reported at least one of the following end points: anastomotic dehiscence, pneumonia, wound infection, nasogastric tube reinsertion, vomiting, mortality, length of hospital stay, hospital costs, and quality of life.
  
  
  RESULTS
  Seven trials, which included a total of 587 patients, met our inclusion criteria. Compared with traditional oral feeding, early oral feeding reduced the length of hospital stay (weighted mean difference -1.58 days; 95% CI -2.77 to -0.39; p = 0.009) and the total postoperative complications (relative risk 0.70; 95% CI 0.50-0.98; p = 0.04). There were no significant differences in the risk of anastomotic dehiscence, pneumonia, wound infection, rate of nasogastric tube reinsertion, vomiting, or mortality.
  
  
  CONCLUSIONS
  Early oral feeding is safe and effective in patients undergoing elective colorectal surgery.
authors.affiliation: Department of Gastrointestinal Surgery, The First Affiliated Hospital, Wenzhou Medical College, Wenzhou, China.
authors.forename: Cheng-Le
authors.initials: CL
authors.lastname: Zhuang
authors.forename: Xing-Zhao
authors.initials: XZ
authors.lastname: Ye
authors.forename: Chang-Jing
authors.initials: CJ
authors.lastname: Zhang
authors.forename: Qian-Tong
authors.initials: QT
authors.lastname: Dong
authors.forename: Bi-Cheng
authors.initials: BC
authors.lastname: Chen
authors.forename: Zhen
authors.initials: Z
authors.lastname: Yu
mesh_terms: D057868:Anastomotic Leak / Q000209:etiology; D003106:Colon / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D004750:Enteral Nutrition / Q000009:adverse effects / Q000379:methods*; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay; D011014:Pneumonia / Q000209:etiology; D011182:Postoperative Care / Q000009:adverse effects / Q000379:methods*; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D012007:Rectum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology; D013997:Time Factors; D014839:Vomiting / Q000209:etiology