Early Versus Delayed Oral Feeding in Emergency Gastrointestinal Surgeries.

Background: Early postoperative oral feeding has been documented to improve outcomes in patients who have undergone open or laparoscopic elective bowel surgeries. Available data on the safety and outcomes of early postoperative oral feeding in patients who underwent emergency gastrointestinal surgeries are inconclusive.

Objective: This study was conducted to compare and determine the safety, benefits and outcomes of early postoperative oral feeding and delayed oral feeding after emergency gastrointestinal surgeries.

Methods: Sixty patients who underwent emergency gastrointestinal surgeries were randomized either into the early feeding group (EFG) or the delayed feeding group (DFG). The patients in EFG commenced a graded oral liquid diet on postoperative day 1 (POD 1) while patients in DFG were commenced on a graded oral diet after the return of bowel function. The main endpoints were the need to re-insert the nasogastric tube and the overall length of hospital stay.

Results: The mean age of patients in the EFG and DFG were similar ((33.2±8.94 versus 33.9±8.91; p= 0.7407). Seventeen (56.7%) patients in EFG failed to tolerate early oral feeding compared to 8 (26.7%) patients in DFG who failed to tolerate feeding following the commencement of oral feeding (p= 0.036). Of the patients that were unable to tolerate oral feeding; thirteen (76.5%) of the 17 patients in EFG required re-insertion of NG tube for stomach decompression as compared to two (25%) of the 8 patients in DFG (p=0.0441). The mean length of hospital stay was longer in EFG (9±2.34 vs 6.5±1.04; p<0.001).

Conclusion: Early postoperative oral feeding in patients who underwent emergency gastrointestinal surgeries was associated with a high failure rate and increased risk of postoperative complications with a prolonged length of hospital stay.