Nematihonar Behzad, Salimi Sohrab, Noorian Vahid, Samsami Majid
Department of General Surgery, Imam-Hossein General Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Anesthesiology, Imam-Hossein General Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Adv Biomed Res. 2018 Feb 16;7:30. doi: 10.4103/abr.abr_290_16. eCollection 2018.
A period of starvation after colorectal anastomosis to permit for resolution of the clinical evidence of ileus has been an unchallenged surgical dogma until recent years. We intended to determine the safety and feasibility of an unconventional postoperative oral intake protocol in patients experiencing colorectal anastomosis.
Between 2013 and 2015, sixty consecutive patients underwent colorectal anastomosis and they were randomized into two groups. The early feeding group began fluids on the first postoperative day while the regular feeding group was managed in the traditional way - nothing by mouth until the complete resolution of ileus.
The majority of patients (93%) tolerated the early feeding. The times to first passage of flatus (2.66 ± 0.71 days vs. 3.9 ± 0.071 days) and stool (3.9 ± 0.92 days vs. 5.4 ± 0.77 days) were significantly quicker in early feeding group. Hospital stay was also significantly shorter in the early feeding group (4 ± 0.64 days vs. 6.1 ± 0.84 days). Anastomosis leakage and abscess formation were not seen in early feeding group. The patient's satisfaction (visual analog scale) in the early feeding group was higher than delayed feeding group (8.56 ± 1.16 vs. 7.06 ± 1.59, < 0.001).
Early oral feeding after colorectal surgeries is safe and tolerated by the majority of patients.
直到近年来，结直肠吻合术后进行一段时间的禁食以促进肠梗阻临床症状的缓解一直是外科界无可争议的教条。我们旨在确定一种非常规的术后口服摄入方案在接受结直肠吻合术患者中的安全性和可行性。
2013年至2015年期间，连续60例患者接受了结直肠吻合术，并被随机分为两组。早期喂养组术后第一天开始进流食，而常规喂养组则采用传统方式处理——直至肠梗阻完全缓解前禁食。
大多数患者（93%）耐受早期喂养。早期喂养组首次排气时间（2.66±0.71天对3.9±0.071天）和首次排便时间（3.9±0.92天对5.4±0.77天）明显更快。早期喂养组的住院时间也明显更短（4±0.64天对6.1±0.84天）。早期喂养组未出现吻合口漏和脓肿形成。早期喂养组患者的满意度（视觉模拟评分）高于延迟喂养组（8.56±1.16对7.06±1.59，<0.001）。
结直肠手术后早期口服喂养是安全的，且大多数患者能够耐受。
