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Cited by 196Enhanced Recovery After SurgeryClinical Nutrition and GastroenterologyGastrointestinal motility and disorders

Randomized clinical trial of the impact of early enteral feeding on postoperative ileus and recovery

Han-Geurts, I J M, Hop, W C J, Kok, N F M, Lim, A, Brouwer, K J, Jeekel, J·2007·British Journal of Surgery
DOI 10.1002/bjs.5753
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Abstract

Background: Postoperative convalescence is mainly determined by the extent and duration of postoperative ileus. This randomized clinical trial evaluated the effects of early oral feeding on functional gastrointestinal recovery and quality of life. Methods: One hundred and twenty-eight patients undergoing elective open colorectal or abdominal vascular surgery participated in the trial. Of these, 67 were randomized to a conventional return to diet, and 61 to a regimen allowing resumption of an oral diet as soon as tolerated (free diet group). Results: Reinsertion of a nasogastric tube was necessary in 20 per cent of the free diet group and 10 per cent of the conventional group (P = 0·213). The complication rate was similar for both groups, as was return of gastrointestinal function. A normal diet was tolerated after a median of 2 days in the free diet group compared with 5 days in the conventional group (P < 0·001). Quality of life scores were similar in both groups. Conclusion: Early resumption of oral intake does not diminish the duration of postoperative ileus or lead to a significantly increased rate of nasogastric tube reinsertion. Tolerance of oral diet is not influenced by gastrointestinal functional recovery. As there is no reason to withhold oral intake following open colorectal or abdominal vascular surgery, postoperative management should include early resumption of diet.

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  • After severe acute pancreatitis, an early oral diet is recommended at least by soft food; solid food is not contraindicated but should be built up to a normal diet within days, judging by abdominal pain and postprandial pain.

    “an early oral diet is”

    From ESPEN guideline on hospital nutrition (2021) · cites this paper as [206]

    The Abstract reports that patients recovering from elective colorectal or abdominal vascular surgery could resume oral intake as tolerated and reached a normal diet in a median of two days in the free-diet group. The Discussion also reports earlier tolerance of solid food. The paper does not study severe acute pancreatitis or recommend soft food or using abdominal and postprandial pain to guide diet advancement. (LLM, conf=0.88)

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Cites

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Research works printed but not linked: 24

  1. Hill AG. Initiators and propagators of the metabolic response to injury. World J Surg 2000; 24: 624-629.
  2. Desborough JP. The stress response to trauma and surgery. Br J Anaesth 2000; 85: 109-117.
  3. Lin E, Calvano SE, Lowry SF. Inflammatory cytokines and cell response in surgery. Surgery 2000; 127: 117-126.
  4. Basse L, Raskov HH, Hjort Jakobsen D, Sonne E, Billesbolle P, Hendel HW et al. Accelerated postoperative recovery programme after colonic resection improves physical performance, pulmonary function and body composition. Br J Surg 2002; 89: 446-453.
  5. Anderson AD, McNaught CE, MacFie J, Tring I, Barker P, Mitchell CJ. Randomized clinical trial of multimodal optimization and standard perioperative surgical care. Br J Surg 2003; 90: 1497-1504.
  6. Holte K, Kehlet H. Postoperative ileus: a preventable event. Br J Surg 2000; 87: 1480-1493.
  7. Reissman P, Teoh TA, Cohen SM, Weiss EG, Nogueras JJ, Wexner SD. Is early oral feeding safe after elective colorectal surgery? A prospective randomized trial. Ann Surg 1995; 222: 73-77.
  8. Smets EM, Garssen B, Cull A, de Haes JC. Application of the multidimensional fatigue inventory (MFI-20) in cancer patients receiving radiotherapy. Br J Cancer 1996; 73: 241-245.
  9. Brooks R. EuroQol: the current state of play. Health Policy 1996; 37: 53-72.
  10. Stewart BT, Woods RJ, Collopy BT, Fink RJ, Mackay JR, Keck JO. Early feeding after elective open colorectal resections: a prospective randomized trial. Aust N Z J Surg 1998; 68: 125-128.
  11. Schilder JM, Hurteau JA, Look KY, Moore DH, Raff G, Stehman FB et al. A prospective controlled trial of early postoperative oral intake following major abdominal gynecologic surgery. Gynecol Oncol 1997; 67: 235-240.
  12. Ortiz H, Armendariz P, Yarnoz C. Is early postoperative feeding feasible in elective colon and rectal surgery? Int J Colorect Dis 1996; 11: 119-121.
  13. Feo CV, Romanini B, Sortini D, Ragazzi R, Zamboni P, Pansini GC et al. Early oral feeding after colorectal resection: a randomized controlled study. ANZ J Surg 2004; 74: 298-301.
  14. Lewis SJ, Egger M, Sylvester PA, Thomas S. Early enteral feeding versus 'nil by mouth' after gastrointestinal surgery: systematic review and meta-analysis of controlled trials. BMJ 2001; 323: 773-776.
  15. Kehlet H, Williamson R, B üchler MW, Beart RW. A survey of perceptions and attitudes among European surgeons towards the clinical impact and management of postoperative ileus. Colorectal Dis 2005; 7: 245-250.
  16. Lassen K, Dejong CHC, Ljungqvist O, Fearon K, Andersen J, Hannemann P et al. Nutritional support and oral intake after gastric resection in five northern European countries. Dig Surg 2005; 22: 346-352.
  17. Lassen K, Hannemann P, Ljungqvist O, Fearon K, Dejong CHC, von Meyenfeldt MF et al. Patterns in current perioperative practice: survey of colorectal surgeons in five northern European countries. BMJ 2005; 330: 1420-1421.
  18. Zutchi M, Delaney CP, Senagore AJ, Mekhail N, Lewis B, Connor JT et al. Randomized controlled trial comparing the controlled rehabilitation with early ambulation and diet pathway versus the controlled rehabilitation with early ambulation and diet with preemptive epidural anaesthesia/analgesia after laparotomy and intestinal resection. Am J Surg 2005; 189: 268-272.
  19. Henriksen MG, Hansen HV, Hessov I. Early oral nutrition after elective colorectal surgery: influence of balanced analgesia and enforced mobilization. Nutrition 2002; 18: 263-267.
  20. Kehlet H, Wilmore DW. Multimodal strategies to improve surgical outcome. Am J Surg 2002; 183: 630-641.
  21. Fearon KCH, Ljungqvist O, Von Meyenfeldt M, Revhaug A, Dejong CHC, Lassen K et al. Enhanced recovery after surgery: a consensus review of clinical care for patients undergoing colonic resection. Clin Nutr 2005; 24: 466-477.
  22. Demetriades H, Botsios D, Kazantzidou D, Sakkas L, Tsalis K, Manos K et al. Effect of early postoperative enteral feeding on the healing of colonic anastomosis in rats. Eur Surg Res 1999; 31: 57-63.
  23. Schwenk W, Neudecker J, B öhm B, M üller JM. Postoperative short-term course following laparoscopic or conventional resection of colorectal tumors. Minimal Invasive Chirurgie 2002; 11: 112-118.
  24. Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G, Clinical Outcomes of Surgical Therapy (COST) Study Group. Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA 2002; 287: 321-328.

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Authors
Han-Geurts, I. J. M., Hop, W. C. J., Kok, N. F. M., Lim, A., Brouwer, K. J., & Jeekel, J.
Affiliations
  • Department of Surgery Erasmus MC, The Netherlands
  • Erasmus MC (NL)
  • Department of Medical Centre Rijnmond Zuid, location Zuider, Rotterdam, The Netherlands
ORCID
Venue
British Journal of Surgery
Publisher
Oxford University Press (OUP)
Published
2007-04-19
Volume
94
Issue
5
Pages
555-561
ISSN
  • 0007-1323 (ISSN-L)
  • 1365-2168
DOI
10.1002/bjs.5753
OpenAlex
W2040878938
Cited by
196
References
1
Citations by year
2025: 1 · 2024: 7 · 2023: 13 · 2022: 6 · 2021: 5 · 2020: 11 · 2019: 20 · 2018: 11 · 2017: 13 · 2016: 15 · 2015: 12 · 2014: 15 · 2013: 18 · 2012: 10
FWCI
10.32
Type
journal article
Language
en
Open access
closed
Licence
academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations
  • British journal of surgery (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
early enteral nutrition, postoperative ileus, early oral feeding, colorectal surgery, gastrointestinal function recovery, quality of life, postoperative recovery
MeSH terms
Adult, Aged, Aortic Aneurysm, Colorectal Surgery, Enteral Nutrition, Female, Humans, Intubation, Gastrointestinal, Male, Middle Aged, Pain, Pain Measurement, Postoperative Care, Postoperative Complications, Quality of Life, Recovery of Function, Ileus

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