Factors associated with early postoperative feeding: An observational study in a colorectal surgery population.

Atkinson C., Monk VC., Ness AR., Lewis SJ., Longman RJ., Thomas SJ., Leary SD., Hollingworth W., Penfold CM.

BACKGROUND AND AIMS: Early post-operative feeding is recommended within enhanced recovery after surgery programmes. This study aimed to describe post-operative feeding patterns and associated factors among patients following colorectal surgery, using a post-hoc analysis of observational data from a previous RCT on chewing gum after surgery. METHODS: Data from 301 participants (59% male, median age 67 years) were included. Amounts of meals consumed on post-operative days (POD) 1-5 were recorded as: none, a quarter, half, three-quarters, all. 'Early' consumers were those who ate ≥a quarter of a meal on POD1. 'Early' tolerance was the consumption of at least half of three meals on POD1 or 2 without vomiting. Exploration of selected peri-operative factors with early feeding and tolerance were assessed using logistic regression. RESULTS: 222 people (73.8%) consumed solid food early, and 109 people (36.2%) tolerated solid food early. Several factors were associated with postoperative feeding: provision of pre-operative bowel preparation was associated with delayed consumption [odds ratio (OR) 0.34, 95% confidence interval (CI) 0.14-0.83] and tolerance (OR 0.35, 95% CI 0.16-0.81) of food; and laparoscopic/laparoscopic assisted (vs. open/converted to open surgery) was associated with early tolerance of food (OR 1.99, 95% CI 1.17-3.39). CONCLUSIONS: While three-quarters of the study population ate solid food early, only one-third tolerated solid food early. Findings suggest that bowel preparation and surgery type are factors warranting further investigation in future studies to improve uptake of early post-operative feeding.

DOI

10.1016/j.clnesp.2020.01.009

Type

Journal article

Publication Date

2020-04-01T00:00:00+00:00

Volume

36

Pages

99 - 105

Total pages

6

Keywords

Colorectal surgery, Early post-operative feeding, Enhanced recovery, Perioperative care, Adult, Aged, Aged, 80 and over, Colorectal Surgery, Digestive System Surgical Procedures, Enhanced Recovery After Surgery, Feeding Behavior, Female, Food, Humans, Laparoscopy, Logistic Models, Male, Middle Aged, Perioperative Care, Postoperative Complications, Postoperative Period, Young Adult

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