title: Early initiation of oral feeding following upper gastrointestinal tumor surgery: a randomized controlled trial.
abstract: OBJECTIVE
  Despite increasing trends toward the early initiation of oral feeding after gastrointestinal (GI) surgeries, current evidence has not been convincing. The present randomized clinical trial aimed to compare the clinical outcomes of early oral feeding (EOF) with late oral feeding (LOF) following surgery for upper GI tumors.
  
  
  METHODS
  One hundred and nine consecutive patients with esophageal or gastric tumors undergoing surgical resection in two hospitals in Tehran, Iran, were enrolled in this prospective randomized controlled trial, and were randomly assigned to a group starting EOF on the first postoperative day and another group that remained nil by mouth until the return of bowel sounds (LOF group). The clinical and surgical outcomes were compared between the two groups.
  
  
  RESULTS
  The clinical outcomes were significantly better in the patients in the EOF group (p < 0.05). Repeated nil per os (14.8 vs. 30.9 %) and re-hospitalization (1.8 vs. 7.3 %) were more common in LOF group (p < 0.0001). Additionally, gas passage, nasogastric tube (NGT) discharge, a decrease in intravenous serum to less than 1000 ml per day, the time to start a soft diet and hospital discharge following surgery occurred significantly earlier in the EOF group than in the LOF group (p < 0.0001).
  
  
  CONCLUSIONS
  Early oral feeding after the surgical resection of esophageal and gastric tumors is safe, and is associated with favorable early in-hospital outcomes and a sooner return to physiological GI function and hospital discharge.
authors.affiliation: Cancer Institute, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Habibollah
authors.initials: H
authors.lastname: Mahmoodzadeh
authors.forename: Saeed
authors.initials: S
authors.lastname: Shoar
authors.forename: Freydoon
authors.initials: F
authors.lastname: Sirati
authors.forename: Zhamak
authors.initials: Z
authors.lastname: Khorgami
mesh_terms: D000368:Aged; D004750:Enteral Nutrition; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000534:rehabilitation* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors