The Effect of Cisapride on the Success of Early Feeding after Elective Open Colon Resection

Abstract

Early postoperative feeding after open colon resection has been shown to be safe and effective. However, approximately 13 per cent of patients fail to tolerate it. We hypothesized that the use of promotility agents may decrease failure of early postoperative feeding after elective open colectomy. As part of a consecutive case series metoclopramide or cisapride was administered to patients undergoing open colectomy as part of an early feeding protocol. The early feeding protocol consisted of instituting a clear liquid diet on postoperative day (POD) 2, followed by a regular diet on POD 3. One hundred fifty-one patients received early-feeding without promotility agents (Group I). The next 49 patients were treated with metoclopramide (Group II), and 31 patients received cisapride (Group III). In Group I 20 of 151 patients (13.2%) failed early feeding, and the mean hospital stay was 3.77 days (range 3-11 days). In Group II seven of 49 patients (14.2%) failed early postoperative feeding, and the mean hospital stay was 3.67 days (range 3-8 days). Group III had no patients who failed to tolerate early feeding, and the mean hospital stay was 3.32 days (range 3-5 days). There were no anastomotic leaks or abdominal abscesses in any group. No cardiac arrhythmias were associated with cisapride. A decrease in early feeding failure was observed with cisapride, administration.