Application of Early Oral Feeding after Colorectal Cancer Surgery in Fast-Track_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHOU Yin ^1,2 , YANG Tinghan ^1,2 , WANG Xiaodong ^2,3 , LI Li ^2,3

1.West China Medical School/West China Hospital, Sichuan University, Chengdu 610041, China;;
2.West China Hospital MCQ Team, Sichuan University, Chengdu 610041, China;;
3.Center of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041， China;

Corresponding author：

Keywords：

Early feeding; Colorectal cancer; Fast-track

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To discuss the feasibility and safety of early oral feeding after colorectal cancer resection and early postoperative recovery condition.
Methods Between January 2008 and June 2008, 128 patients diagnosed definitely as colorectal cancer were analyzed retrospectively. Fifty-six cases were treated with early oral feeding (EOF group), and 72 cases were treated with traditional feeding (TF group). The length of postoperative hospital stay, time of first flatus and defecation, and incidences of gastric retention, ileus, severe diarrhea, anastomotic leakage, wound infection, and pulmonary infection were studied and compared.
Results The postoperative hospital stay, time of first flatus and defecation in EOF group were apparently shorter than those in TF group (P lt;0.05). As to the incidence of postoperative complications, EOF group had a higher incidence of gastric retention (P lt;0.05), while the differences of incidences of ileus, severe diarrhea, anastomotic leakage, wound infection, and pulmonary infection were not statistically significant between the two groups (P gt;0.05). Early oral feeding can be tolerated by as much as 89.29% (50/56) patients.
Conclusion Early oral feeding after colorectal cancer resection is safe and feasible, and can promote early rehabilitation of patients.

Citation： ZHOU Yin ,YANG Tinghan,WANG Xiaodong,LI Li. Application of Early Oral Feeding after Colorectal Cancer Surgery in Fast-Track. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(5): 500-503. doi: Copy

1.	Wille-Jrgensen P, Guenaga KF, Castro AA, et al. Clinical value of preoperative mechanical bowel cleansing in elective colorectal surgery: a systematic review [J]. Dis Colon Rectum, 2003; 46(8): 1013-1020.
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5.	Basse L, Billesblle P, Kehlet H, et al. Early recovery after abdominal rectopexy with multimodal rehabilitation [J]. Dis Colon Rectum, 2002; 45(2): 195-199.
6.	Langelotz C, Spies C, Müller JM, et al. “Fast-track” rehabilitation in surgery, a multimodal concept [J]. Acta Chir Belg, 2005; 105(6): 555-559.
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8.	Heslin MJ, Latkany L, Leung D, et al. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy[J]. Ann Surg, 1997; 226(4): 577-580.
9.	Feo CV, Lanzara S, Sortini D, et al. Fast track postoperative management after elective colorectal surgery: a controlled trail [J]. Am Surg, 2009; 75(12): 1247-1251.
10.	Camberos A, Cymerman J, DiFronzo LA, et al. The effect of cisapride on the success of early feeding after elective open colon resection [J]. Am Surg, 2002; 68(12): 1093-1096.
11.	Petrelli NJ, Cheng C, Driscoll D, et al. Early postoperative oral feeding after colectomy: an analysis of factors that may predict failure [J]. Ann Surg Oncol, 2001; 8(10): 796-800.
12.	Lewis SJ, Egger M, Sylvester PA, et al. Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials [J]. BMJ, 2001; 323(7316): 773-776.
13.	Buchmann P, Bischofberger U, De Lorenzi D, et al. Early postoperative nutrition after laparoscopic and open colorectal resection [J]. Swiss Surg, 1998; 4(3): 146-155.
14.	Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus [J]. World J Surg, 2006; 30(8): 1382-1391.
15.	Reissman P, Teoh TA, Cohen SM, et al. Is early oral feeding safe after elective colorectal surgery? A prospective randomized trial [J]. Ann Surg, 1995; 222(1): 73-77.
16.	Correia MI, da Silva RG. The impact of early nutrition on metabolic response and postoperative ileus [J]. Curr Opin Clin Nutr Metab Care, 2004; 7(5): 577-583.
17.	Repin VN, Tkachenko IM, Gudkov OS, et al. Enteral tube feeding early after surgery on the stomach and the Duodenum [J]. Khirurgiia (MOSK), 2002; (12): 21-25.
18.	Kaur N, Gupta MK, Minocha VR. Early enteral feeding by nasoenteric tubes in patients with perforation peritonitis [J]. World J Surg, 2005; 29(8): 1023-1027.
19.	Bisgaard T, Kehlet H. Early oral feeding after elective abdominal surgery-what are the issues? [J]. Nutrition, 2002; 18(11-12): 944-948.
20.	Henriksen MG, Hansen HV, Hessov I. Early oral nutrition after elective colorectal surgery: influence of balanced analgesia and enforced mobilization [J]. Nutrition, 2002; 18(3): 263-267.
21.	Henriksen MG, Jensen MB, Hansen HV, et al. Enforced mobilization, early oral feeding, and balanced analgesia improve convalescence after colorectal surgery [J]. Nutrition, 2002;18(2): 147-152.
22.	Luckey A, Livingston E, Taché Y. Mechanisms and treatment of postoperative ileus [J]. Arch Surg, 2003; 138(2): 206-214.
23.	Villalba Ferrer F, Bruna Esteban M, García Coret MJ, et al. Evidence of early oral feeding in colorectal surgery [J]. Rev Esp Enferm Dig, 2007; 99(12): 709-713.

1. Wille-Jrgensen P, Guenaga KF, Castro AA, et al. Clinical value of preoperative mechanical bowel cleansing in elective colorectal surgery: a systematic review [J]. Dis Colon Rectum, 2003; 46(8): 1013-1020.
2. Ng WQ, Neill J. Evidence for early oral feeding of patients after electiveopen colorectal surgery: a literature review [J]. J Clin Nurs, 2006; 15(6): 696-709.
3. Kehlet H. Fast-track colorectal surgery [J]. Lancet, 2008; 371(9615): 791-793.
4. 刘展，汪晓东，李立. 结直肠外科快速流程内容及依据 [J]. 中国普外基础与临床杂志， 2007； 14(4): 469-473.
5. Basse L, Billesblle P, Kehlet H, et al. Early recovery after abdominal rectopexy with multimodal rehabilitation [J]. Dis Colon Rectum, 2002; 45(2): 195-199.
6. Langelotz C, Spies C, Müller JM, et al. “Fast-track” rehabilitation in surgery, a multimodal concept [J]. Acta Chir Belg, 2005; 105(6): 555-559.
7. Reynolds JV, Kanwar S, Welsh FK, et al. Dose the route of feeding modify gut barrier function and clinical outcome in patients after major upper gastrointestinal surgery? [J]. JPEN, 1997; 21(4): 196-201.
8. Heslin MJ, Latkany L, Leung D, et al. A prospective, randomized trial of early enteral feeding after resection of upper gastrointestinal malignancy[J]. Ann Surg, 1997; 226(4): 577-580.
9. Feo CV, Lanzara S, Sortini D, et al. Fast track postoperative management after elective colorectal surgery: a controlled trail [J]. Am Surg, 2009; 75(12): 1247-1251.
10. Camberos A, Cymerman J, DiFronzo LA, et al. The effect of cisapride on the success of early feeding after elective open colon resection [J]. Am Surg, 2002; 68(12): 1093-1096.
11. Petrelli NJ, Cheng C, Driscoll D, et al. Early postoperative oral feeding after colectomy: an analysis of factors that may predict failure [J]. Ann Surg Oncol, 2001; 8(10): 796-800.
12. Lewis SJ, Egger M, Sylvester PA, et al. Early enteral feeding versus “nil by mouth” after gastrointestinal surgery: systematic review and meta-analysis of controlled trials [J]. BMJ, 2001; 323(7316): 773-776.
13. Buchmann P, Bischofberger U, De Lorenzi D, et al. Early postoperative nutrition after laparoscopic and open colorectal resection [J]. Swiss Surg, 1998; 4(3): 146-155.
14. Mattei P, Rombeau JL. Review of the pathophysiology and management of postoperative ileus [J]. World J Surg, 2006; 30(8): 1382-1391.
15. Reissman P, Teoh TA, Cohen SM, et al. Is early oral feeding safe after elective colorectal surgery? A prospective randomized trial [J]. Ann Surg, 1995; 222(1): 73-77.
16. Correia MI, da Silva RG. The impact of early nutrition on metabolic response and postoperative ileus [J]. Curr Opin Clin Nutr Metab Care, 2004; 7(5): 577-583.
17. Repin VN, Tkachenko IM, Gudkov OS, et al. Enteral tube feeding early after surgery on the stomach and the Duodenum [J]. Khirurgiia (MOSK), 2002; (12): 21-25.
18. Kaur N, Gupta MK, Minocha VR. Early enteral feeding by nasoenteric tubes in patients with perforation peritonitis [J]. World J Surg, 2005; 29(8): 1023-1027.
19. Bisgaard T, Kehlet H. Early oral feeding after elective abdominal surgery-what are the issues? [J]. Nutrition, 2002; 18(11-12): 944-948.
20. Henriksen MG, Hansen HV, Hessov I. Early oral nutrition after elective colorectal surgery: influence of balanced analgesia and enforced mobilization [J]. Nutrition, 2002; 18(3): 263-267.
21. Henriksen MG, Jensen MB, Hansen HV, et al. Enforced mobilization, early oral feeding, and balanced analgesia improve convalescence after colorectal surgery [J]. Nutrition, 2002;18(2): 147-152.
22. Luckey A, Livingston E, Taché Y. Mechanisms and treatment of postoperative ileus [J]. Arch Surg, 2003; 138(2): 206-214.
23. Villalba Ferrer F, Bruna Esteban M, García Coret MJ, et al. Evidence of early oral feeding in colorectal surgery [J]. Rev Esp Enferm Dig, 2007; 99(12): 709-713.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of Early Oral Feeding after Colorectal Cancer Surgery in Fast-Track

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