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First-Day Feeding After Colon Cancer Surgery Is Feasible: Presented at SSO

By John Gever

WASHINGTON, DC -- March 20, 2007 -- Patients undergoing colon cancer surgery can eat solid foods the first day after the procedure without danger of complications, according to research presented here at the 60^th annual meeting of the Society of Surgical Oncology (SSO).

Normally, even liquid foods are withheld from these patients until the third day after surgery.

Adrian Cravioto, MD, surgical oncology physician, Instituto Mexicano del Seguro Social, Mexico City, Mexico, reported results of a randomised, prospective trial of early feeding in patients undergoing elective surgery with anastomosis for colon cancer.

Patients who received food on the first postoperative day showed no extra morbidity compared with those fed on a traditional schedule. They also recovered normal intestinal function more quickly, and the duration of hospitalisation was significantly shorter.

In an oral presentation March 17^th, Dr. Cravioto said, "We made the conclusion that early oral feeding and early postoperative discharge following radical colectomy for colon adenocarcinoma is feasible and safe."

The trial enrolled 63 patients with uncomplicated disease who were otherwise in good health. They were assigned to receive either a traditional feeding schedule after surgery, in which liquid foods were introduced on the third postoperative day, or to receive liquid foods followed by solid foods on the first day after surgery regardless of passage of flatus. Patients knew which schedule they were on, but evaluations of postoperative morbidity were blinded to the feeding assignments.

There were no significant differences between feeding groups in rates of surgical complications, such as infection and abscess, intestinal occlusion, anastomosis leakage, need for re-intervention or operative death. All these complications were infrequent, with no more than 3 cases occurring in each group, Dr. Cravioto said.

Rates of nausea and vomiting were also similar in the 2 groups. The only significant differences were both in favour of early feeding: hospital length of stay was shorter (5.31 vs. 7.35 days, P = .0001), and resumption of normal intestinal function was faster (2.5 vs. 3.6 days, P = .01).

Two other factors besides traditional feeding were associated with extended hospital stay. These were age over 70 years and surgical re-intervention.

When questioned about the early discharge conclusion, Dr. Cravioto conceded that this was judged by Mexican standards. In the United States, colectomy patients without complications seldom remain hospitalised for 7 days.


[Presentation title: Prospective Randomized Trial of Early Feeding and Hospital Discharge Following Elective Colon Cancer Surgery With Primary Anastomosis. Abstract 88]

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