Guidelines For Clinical Practice
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World J Gastrointest Oncol. Apr 15, 2010; 2(4): 187-191
Published online Apr 15, 2010. doi: 10.4251/wjgo.v2.i4.187
Early postoperative feeding in resectional gastrointestinal surgical cancer patients
Emma J Osland, Muhammed Ashraf Memon
Emma J Osland, Department of Surgery and Nutrition, Ipswich Hospital, Ipswich, Queensland 4305, Australia; Department of Mathematics and Computing, Australian Centre for Sustainable Catchments, University of Southern Queensland, Toowoomba, Queensland 4305, Australia
Muhammed Ashraf Memon, Department of Surgery and Nutrition, Ipswich Hospital, Ipswich, Queensland 4305, Australia; Department of Surgery, University of Queensland, Brisbane, Queensland 4305, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland 4305, Australia; School of Health and Social Sciences, University of Bolton, Bolton, Lancashire BL3 5AB, United Kingdom
Author contributions: Both authors were involved in drafting the manuscript and critically revising it for important intellectual content. Furthermore, both authors have participated sufficiently in the work to take public responsibility for its content.
Correspondence to: Muhammed Ashraf Memon, FRCS, FRACS, Professor, Department of Surgery and Nutrition, Ipswich Hospital, Chelmsford Avenue, Ipswich, Queensland 4305, Australia.
Telephone: +61-7-32814455 Fax: +61-7-32814456
Received: March 9, 2009
Revised: August 26, 2009
Accepted: September 2, 2009
Published online: April 15, 2010

Malnutrition is present in the majority of patients presenting for surgical management of gastrointestinal malignancies, due to the effects of the tumour and preoperative anti-neoplastic treatments. The traditional practice of fasting patients until the resumption of bowel function threatens to further contribute to the malnutrition experienced by these patients. Furthermore, the rationale behind this traditional practice has been rendered obsolete through developments in anaesthetic agents and changes to postoperative analgesia practices. Conversely, there is a growing body of literature that consistently demonstrates that providing oral or tube feeding proximal to the anastomosis within 24 h postoperatively, is not only safe, but might be associated with significant benefits to the postoperative course. Early post operative feeding should therefore be adopted as a standard of care in oncology patients undergoing gastrointestinal resections.

Keywords: Early feeding, Surgery, Meta-analysis, Randomised controlled trials