Yousaf Jan, Siddique Ahmad, Waqas, Aurangzeb Khan, Irfan-ul Islam Nasir, Rumman Khan.
Comparison of early versus delayed oral feeding in elective intestinal anastomosis.
Pak J Surg Jan ;30(2):120-7.

Background: Diff erent abdominal surgeries could benefi t from early feeding. Objective: Th is study was conducted to evaluate the outcome of early versus traditional delayed oral feeding in elective cases undergoing small or large intestinal anastomosis. Materials and Methods : In the period from Feb 2011 to Feb 2013, this study included 120 patients who underwent elective intestinal anastomosis, they were randomly assigned into two groups in a consecutive manner as either the early oral feeding group (Group A) or delayed traditional oral feeding group (Group B) with 60 patients in each group . Patients were followed up for a period of one month. Results: A total of 120 patients were divided into two groups, with 60 patients in the early oral feeding (EOF) group and 60 in the delayed oral feeding (DOF) group. In EOF group age ranged from (22-69) years with a mean age of (46.15±14.39) and the majority of them were males (63%). In DOF group patient age ranged from (18-67) years with a mean age of (42.1±15.79) years with male predominance (53%). In group A, ileostomy closure was done in 44 patients (73.3%), colostomy closure in 14 patients (23.3%) and ileocolic anastomosis in 2 cases (3.3%). In group B, ileostomy closure was done in 42 patients (70%), colostomy closure in 15 cases (25%) and ileocolic anastomosis in 3 cases (5%). Th e mean starting time of oral feeding for the two groups were (2.02±0.16) and (5.75±1.32) days for the EOF and DOF groups, respectively (p=0.00). Fift y four patients (90%) in the EOF and fi ft y one patients (85%) in the DOF group tolerated the oral feeding successfully. Mean time for appearance of bowel sounds was (1.08±0.27) and (3.01±0.6) days in EOF and DOF groups respectively (p=0.000). In group A, post-operative hospital stay ranged between (4-5) days, while in group B, the range of post-operative stay was (7-15) days. Th ree patients (4.8%) in group A and seven patients (11.2%) in group B had wound discharge which was purulent in one case (1.6%) of group A and fi ve cases (8.3%) of group B (p=0.103). Two patients (3.2%) in group A and eight patients (13.3%) in group B had anastomotic leak in the post-operative period (p=0.04) which is statistically signifi cant. Two patients (3.2%) in group B died, both because of sepsis and DIC due to anastomotic leak, and no mortality was noted in group A patient (p=0.2479). Conclusion: Early oral feeding aft er elective intestinal anastomosis is well tolerated, helps in early resolution of ileus, decreased wound infection and short hospital stay

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com