Fujii Takaaki, Morita Hiroki, Sutoh Toshinaga, Yajima Reina, Yamaguchi Satoru, Tsutsumi Soichi, Asao Takayuki, Kuwano Hiroyuki
Department of General Surgical Science, Graduate School of Medicine, Gunma University, Gunma, Japan.
Int Surg. 2014 May-Jun;99(3):211-5. doi: 10.9738/INTSURG-D-13-00146.1.
The optimal timing of early oral intake after surgery has not been fully established. The objective of this study was to compare early oral intake at postoperative day 1 after resection of colorectal cancer with that of day 2 to identify the optimal timing for resumption of oral intake in such patients. Consecutive patients with colorectal cancer who underwent elective colorectal resection were separated into two groups. Sixty-two patients began a liquid diet on the first postoperative day (POD1 group) and 58 patients began on POD2 (POD2 group) and advanced to a regular diet within the next 24 hours as tolerated. As for gastrointestinal recovery, the first passage of flatus was experienced, on average, on postoperative day 3.1 ± 1.0 in the POD2 group and on day 2.3 ± 0.7 in the POD1 group. The first defecation was also significantly earlier in patients in the POD1 group than those in the POD2 group (POD 3.2 ± 1.2 versus 4.2 ± 1.4, respectively). No statistical difference was found between the two groups in terms of postoperative complications. Our results suggest that very early feeding on POD1 after colorectal resection is safe and feasible and that induced a quicker recovery of postoperative gastrointestinal movement in patients.
手术后早期经口进食的最佳时机尚未完全确定。本研究的目的是比较结直肠癌切除术后第1天与第2天的早期经口进食情况,以确定此类患者恢复经口进食的最佳时机。将接受择期结直肠癌切除术的连续患者分为两组。62例患者在术后第1天开始流食(POD1组),58例患者在术后第2天开始流食(POD2组),并在接下来的24小时内根据耐受情况逐渐过渡到正常饮食。至于胃肠道恢复情况,POD2组平均在术后第3.1±1.0天出现首次排气,POD1组在术后第2.3±0.7天出现首次排气。POD1组患者的首次排便也明显早于POD2组患者(分别为术后第3.2±1.2天和第4.2±1.4天)。两组术后并发症方面未发现统计学差异。我们的结果表明,结直肠癌切除术后第1天尽早进食是安全可行的,并且能促使患者术后胃肠蠕动更快恢复。