Early Enteral Feeding Versus Delayed Enteral Nutrition: Effects On Morbidity After Intestinal Surgery; A Prospective Study

Abstract

Routine practice after bowel anastomoses has been to keep patient nil per oral till the return of bowel sound with a belief that this will prevent postoperative nausea and vomiting and protect the anastomotic site where, however this trend had been changed to encourage enteral feeding as early as possible as various studies has shown early enteral feeding to be beneficial in terms of nutritional, immunological aspect and for faster postoperative recovery of patient.
 Objective; To study and compare the effects of early enteral feeding with those of conventional management in postoperative patients undergoing intestinal primary suturing or direct repair.
 Patients and methods ; A prospective interventional study conducted for 135 patients with an age range between 15 – 67 years old who admitted to the general surgery Department in AlKindy Teaching Hospital, Baghdad, Iraq for the period between 1st of March 2019 and 1st October 2021. The patients were randomly assigned to schedule with starting oral feeding on the first day after surgery, referred to as early feeding group and those with delayed oral feeding till first passage of flatus and bowel movement, referred to as regular feeding group and compared overall prevalence of postoperative complication, length of hospital stay and outcome of surgery in these two groups.
 Result; There was less post operative complication in early feeding group as compaired with regular feeding group patients. Twenty percent patients developed post operative vomiting in early feeding group and sixteen percent patients in regular feeding group. Post operative fever occurred in five percent patients in early feeding group while sixteen percent patients in regular feeding group sufferd from postoperative fever. Abdominal distension noted in five percent patients in early feeding group while sixteen percent patients in regular feeding group. The average length of hospital stay in patient belong to early feeding group was 2-5 day while patient in regular feeding group stayed in hospital for average 3-8 days. 
 Conclusion; There is more benefit from early oral feeding than delay oral feeding strategy in incidence of postoperative morbidity and period of hospital stay after intestinal surgery.