Early postoperative feeding in resectional gastrointestinal surgical cancer patients

Table 1 Randomised controlled trials investigating early feeding published since 2005

Study	Year	Types ofGastrointestinal Surgery	n(Trad/Early)	Earlyfeeding protocol	Outcomes
Lucha et al[4]	2005	Open colorectal surgery	25/26	Regular diet from 8 hr following surgery	No difference in post operative complications between groups (1 d vs 1 d) or LOS 6.6 d vs 6.3 d
Zhou et al[5]	2006	Excision and anastomosis for colorectal tumour	155/161	Liquid fibreless diet D1-3 post op	Statistically significant benefits of early feeding Flatus 3.0 ± 0.9 d vs 3.6 ± 1.2 d, P = 0.000 Stool 4.1 ± 1.1 d vs 4.8 ± 1.4 d, P = 0.000 LOS 8.4 ± 3.4 d vs 9.6 ± 5.0 d, P = 0.016 Reduced complications with early feeding Reduced febrile illness: 3 vs 15, P = 0.042 Pulmonary infection: 1 vs 7, P = 0.034 Pharyngolaryngitis: 5 vs 36, P = 0.000 No differences in wound complications 4 vs 3, P = 1.0 No differences in anastomotic leakage 2 vs 4, P = 0.441
Han-Geurts et al[6]	2007	Open colorectal surgery	50/46	Regular diet from D1 post op	No statistically significant differences in outcomes between groups in any in-hospital complication, including mortality. No statistically significant differences between return of bowel function and length of hospital stay between groups
Lassen et al[7]	2008	Hepatic, pancreatic, oesophageal, gastric resections, bilioenteric and gastroenteric bypass procedures, unspecified procedures in which traditional NBM management would be indicated	227/220	Early oral feeding provided with ordinary hospital diet from D1 post op NB control group received enteral nutrition via a jejunostomy tube from D1 post op	No differences between number of patients major complications between groups (33% in jejunum fed vs 28% early oral, P = 0.26); less overall complications in early oral feeding group (100 vs 165, P = 0.012) No differences in mortality between groups within the trial period (8.4% early jejunum feeding vs 5.9% early oral, P = 0.36) Increased likelihood of intra-abdominal abscesses in gastrectomy patients with early jejunum feeding vs early oral intake (6 vs 0, P = 0.012) Shorter duration to passage of flatus early oral feeding group (2.6 vs 3.0 d, P = 0.01); no difference for duration to first bowel motion (4.3 vs 4.0 d, P = 0.112) Longer length of stay with jejunum fed patients (16.7 vs 13.5 d, P = 0.046)