EARLY FEEDING AFTER ELECTIVE OPEN COLORECTAL RESECTIONS: A PROSPECTIVE RANDOMIZED TRIAL

Background: A period of starvation after colorectal resections to allow for resolution of the clinical evidence of ileus has been an unchallenged surgical doctrine until recent times. A prospective randomized trial comparing early feeding to traditional management in patients undergoing open electiv...

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Veröffentlicht in:Australian and New Zealand Journal of Surgery 1998-02, Vol.68 (2), p.125-128
Hauptverfasser: Stewart, B. T., Woods, R. J., Collopy, B. T., Fink, R. J., Mackay, J. R., Keck, J. O.
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container_end_page 128
container_issue 2
container_start_page 125
container_title Australian and New Zealand Journal of Surgery
container_volume 68
creator Stewart, B. T.
Woods, R. J.
Collopy, B. T.
Fink, R. J.
Mackay, J. R.
Keck, J. O.
description Background: A period of starvation after colorectal resections to allow for resolution of the clinical evidence of ileus has been an unchallenged surgical doctrine until recent times. A prospective randomized trial comparing early feeding to traditional management in patients undergoing open elective colorectal resections is reported. Methods: Patients undergoing elective intraperitoneal colorectal resections without stoma formation were randomized to either an early feeding or control group. The early feeding group were allowed free fluids from 4 h postoperatively progressing to a solid diet from the first postoperative day as they tolerated it. The control group remained nil orally until passage of flatus or bowel motion and were then commenced on fluids progressing to solids over 24–48 h. Results: There were 40 patients in each group well matched for age, sex, type and duration of operation, method of analgesia and mobilization. Thirty‐two patients (80%) in the early feeding group tolerated a diet within 48 h. There was no significant difference in the rate of vomiting, nasogastric reinsertion or complications. The early feeding group tolerated a diet, passed flatus, used their bowels, and were discharged from hospital significantly earlier than the control group. Conclusion: Early feeding after elective open colorectal resections is successfully tolerated by the majority of patients, leading to earlier resolution of ileus and hospital discharge.
doi_str_mv 10.1111/j.1445-2197.1998.tb04721.x
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The control group remained nil orally until passage of flatus or bowel motion and were then commenced on fluids progressing to solids over 24–48 h. Results: There were 40 patients in each group well matched for age, sex, type and duration of operation, method of analgesia and mobilization. Thirty‐two patients (80%) in the early feeding group tolerated a diet within 48 h. There was no significant difference in the rate of vomiting, nasogastric reinsertion or complications. The early feeding group tolerated a diet, passed flatus, used their bowels, and were discharged from hospital significantly earlier than the control group. 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T.</creatorcontrib><creatorcontrib>Woods, R. J.</creatorcontrib><creatorcontrib>Collopy, B. T.</creatorcontrib><creatorcontrib>Fink, R. J.</creatorcontrib><creatorcontrib>Mackay, J. R.</creatorcontrib><creatorcontrib>Keck, J. O.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Australian and New Zealand Journal of Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stewart, B. T.</au><au>Woods, R. J.</au><au>Collopy, B. T.</au><au>Fink, R. J.</au><au>Mackay, J. R.</au><au>Keck, J. O.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>EARLY FEEDING AFTER ELECTIVE OPEN COLORECTAL RESECTIONS: A PROSPECTIVE RANDOMIZED TRIAL</atitle><jtitle>Australian and New Zealand Journal of Surgery</jtitle><addtitle>Aust N Z J Surg</addtitle><date>1998-02</date><risdate>1998</risdate><volume>68</volume><issue>2</issue><spage>125</spage><epage>128</epage><pages>125-128</pages><issn>0004-8682</issn><eissn>1445-2197</eissn><abstract>Background: A period of starvation after colorectal resections to allow for resolution of the clinical evidence of ileus has been an unchallenged surgical doctrine until recent times. A prospective randomized trial comparing early feeding to traditional management in patients undergoing open elective colorectal resections is reported. Methods: Patients undergoing elective intraperitoneal colorectal resections without stoma formation were randomized to either an early feeding or control group. The early feeding group were allowed free fluids from 4 h postoperatively progressing to a solid diet from the first postoperative day as they tolerated it. The control group remained nil orally until passage of flatus or bowel motion and were then commenced on fluids progressing to solids over 24–48 h. Results: There were 40 patients in each group well matched for age, sex, type and duration of operation, method of analgesia and mobilization. Thirty‐two patients (80%) in the early feeding group tolerated a diet within 48 h. There was no significant difference in the rate of vomiting, nasogastric reinsertion or complications. The early feeding group tolerated a diet, passed flatus, used their bowels, and were discharged from hospital significantly earlier than the control group. 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source MEDLINE; Access via Wiley Online Library
subjects Adult
Aged
Aged, 80 and over
Anastomosis, Surgical
Australia
Blood Loss, Surgical
Colectomy - methods
colorectal
Elective Surgical Procedures
Enteral Nutrition
feeding
Female
Humans
ileus
Intestinal Obstruction - therapy
Length of Stay
Male
Matched-Pair Analysis
Middle Aged
nutrition
Postoperative Care
Proportional Hazards Models
Prospective Studies
Rectum - surgery
surgery
title EARLY FEEDING AFTER ELECTIVE OPEN COLORECTAL RESECTIONS: A PROSPECTIVE RANDOMIZED TRIAL
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