Early versus delayed oral feeding in emergency intestinal resection anastomosis with or without covering stoma

Abstract EN

Background : Early oral feeding is an essential part of fast track surgery which has evolved as a result of coordinated effort to combine recent evidence based advances in the modern care of surgical patients.

Fast track rehabilitation or enhanced recovery after surgery is a multimodal program aiming at enhancing postoperative recovery and outcome.

Objective : This study was conducted to evaluate the outcome of early oral feeding which is an integral part of fast track rehabilitation program versus delayed oral feeding in emergency cases undergoing small or large intestinal resection anastomosis with or without covering stoma.

Methods : This study included 40 patients who underwent urgent intestinal resection with or without covering stoma.

They were randomly allocated into two groups, group (A) included 20 patients with early oral feeding and group (B) with delayed oral feeding.

Results : Early oral feeding is safe in the recently performed anastomosis even in emergency situations as there were no cases of clinical anastomotic leak and no increase in morbidity.

Two patients (10 %) in group A had chest infection versus five (25 %) in group B, (P = 0.407).

Three patients (15 %) in group A had wound infection versus seven(35 %) in group B, (P = 0.273).

Three patients (15 %) in group B had burst abdomen, but no cases were recorded in group A, (P = 0.231).

Four patients (20 %) had vomiting in group A versus two (10 %) in group B, ( P = 0.661).

Three patients (15 %) had abdominal distension in group A versus two (10 %) in group B, (P = 1.000).

Hospital stay was significantly shorter in group A than group B with a mean length of stay (4.4 ± 2.9) versus (8.6 ± 1.6) days respectively (P < 0.001).

No hospital readmission rate was recorded in both groups.

Conclusions : Early postoperative feeding is safe, tolerable after emergency intestinal resection anastomosis without increase in morbidity and mortality and has a considerable reduction in hospital stay with its physical, psychological and economic benefits.