SEARCHSYSTEMATIC_REVIEWsurgery, gastroenterology

systematic_review·surgery, gastroenterology, clinical nutrition, systematic review·PMC10475250

Tolerance to and Postoperative Outcomes With Early Oral Feeding Following Elective Bowel Surgery: A Systematic Review

Cureus · 2 authors, 2 centres

AI SUMMARY

FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

The review suggests that the only clear benefit of early feeding is a shorter length of hospitalization for those who tolerate it.

Full summary

493 CHARS

The primary finding is that while most patients tolerate EOF, 5-25% may not tolerate it until the fourth postoperative day (POD). Inconsistently reported benefits included earlier return of bowel function, lower diarrhea risk, and lower pain scores. The authors conclude that the only clear benefit for patients who tolerate EOF is a shorter hospital stay, which could reduce costs. Limitations include heterogeneity in study design, setting, and population, which may affect generalizability.

STUDY TYPE

systematic_review

SPECIALTY

surgery

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10475250

Tolerance to and Postoperative Outcomes With Early Oral Feeding Following Elective Bowel Surgery: A Systematic Review

Cureus

READ THE FULL PAPER

ABSTRACT

Although practice guidelines recommend resuming oral feeding immediately after gastrointestinal surgery, many practitioners remain reluctant to order early oral feeding (EOF). Therefore, this review aimed to clarify the tolerance to and postoperative outcomes with EOF among patients undergoing bowel surgery. A systematic review of the literature published between January 1990 and July 2022 with the time of oral intake (early or delayed until resolution of ileus) as the exposure variable was conducted using PubMed and Scopus databases. Outcomes of interest included tolerance to EOF and postoperative adverse effects or complications. After screening 1,667 research articles, 18 randomized control trials, six prospective case series, and four cohort studies met our inclusion criteria, collectively representing data from 2,647 patients in eleven countries. These studies indicate that while most patients tolerate EOF, 5-25% may not tolerate EOF until the fourth postoperative day (POD). Moreover, EOF, at best, has no advantage over delayed feeding in terms of vomiting, nausea, nasogastric tube requirement, or other postoperative complications. In addition, early return of bowel function, lower risk of diarrhea, and lower pain score with EOF are inconsistently reported, and shorter hospitalization with EOF may be limited to those who tolerate oral feeding on POD 0 or 1. Nevertheless, shorter hospitalization with EOF could reduce the cost of hospitalization. A substantial number of patients may not be able to tolerate oral feeding after bowel surgery until POD 4, and in patients who tolerate EOF, the only clear benefit is a shorter length of hospitalization.

CITATION EXPORT

Lord Mvoula, Evelyn Irizarry. Tolerance to and Postoperative Outcomes With Early Oral Feeding Following Elective Bowel Surgery: A Systematic Review. Cureus. (2023). https://doi.org/10.7759/cureus.42943

AUTHORS

2 · 2 CENTRES

Lord Mvoula, Evelyn Irizarry

1 Surgery, Lincoln Medical and Mental Health Center, Bronx, USA
2 Colorectal Surgery, Lincoln Medical and Mental Health Center, Bronx, USA

EDITOR / REVIEWER

Alexander Muacevic, John R Adler