Early Postoperative Feeding following Colon Cancer Surgery: A Randomized Controlled Trial

Kenshi Hiratsuka, Akira Tsunoda, Miki Shibusawa and Mitsuo Kusano

Second Department of Surgery, Showa University School of Medicine

Background: We assessed the feasibility of early feeding following the resolution of gastric ileus in patients having elective open colonic surgery. Methods: This was a randomized controlled trial of 26 patients who were assigned to 1 of the 2 groups: Group A: patients were not forced to be mobile and allowed a diet following flatus or defecation. Group B: patients encouraged to be mobile postoperatively. A radiopaque marker was given orally on the first postoperative morning and X-ray film was taken daily until more than 70% of markers exited the stomach. Then patients received a diet regardless of flatus or defecation. Results: No significant differences were noted in age, gender, or type of procedures in either group. No patient vomited postoperatively. No significant difference was seen in the incidence of complications. The time to first flatus in group B (median, 48 hours) was significantly shorter than that in group A (median, 67 hours) (p=0.03). No significant difference in nutritional parameters was found in either group. The length of hospitalization in group B (median, 7 days) was significantly shorter than that in group A (median, 10 days) (p=0.02). Conclusion: Early feeding following the resolution of gastric ileus is safe and feasible without vomiting in patients who have elective colonic surgery.

Key words
early oral feeding, colon resection, gastric ileus, rapid turnover protein

Reprint requests
Kenshi Hiratsuka Second Department of Surgery, Showa University School of Medicine 1-58 Hatanodai, Shinagawa-ku, Tokyo, 142-8666 JAPAN

Accepted
April 30, 2003

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