Early enteral nutrition within 24h of colorectal surgery versus later commencement of feeding for postoperative complications

Abstract

Although non-significant results, there is no obvious advantage in keeping patients 'nil by mouth' following gastrointestinal surgery, and this review support the notion on early commencement of enteral feeding.

A modified fast-track program for pancreatic surgery: a prospective single-center experience

“…When assessed using the principles of evidence-based medicine, these concepts have been questioned with regard to efficacy. In a meta-analysis of 13 randomized controlled trials with a total of 1,173 participants undergoing gastrointestinal surgery, no advantage was appreciated in keeping patients "nil by mouth" following surgery, as early feeding reduced the incidence of anastomotic leakage, length of hospital stay, and mortality [1]. Moreover, a further meta-analysis of six randomized trials investigating prophylactic drainage for colorectal surgery found no benefit in routine drainage in elective colonic surgery [2].…”

Advantages of fast-track recovery after laparoscopic right hemicolectomy for colon cancer

“…It concluded that early feeding is safe and that it reduces the risk of postoperative complications [3]. Moreover, a systematic review of enhanced recovery programs concluded that these regimens are safe and do shorten postoperative LOS after open colectomy [4].…”

Nutrition périopératoire en chirurgie digestive

“…Dans la période postopératoire, une alimentation orale sera reprise précocement (dans les premières 24 heures) selon la tolérance du patient et en dehors de contre indication chirurgicale. Une récente méta analyse rassemblant 14 études randomisées comparant une reprise précoce par rapport à une reprise tardive de la nutrition orale confirme l'absence d'avantage de maintenir les patients à jeun après chirurgie colorectale ; il semble même qu'une reprise précoce puisse être associée à un meilleur devenir [2].…”