Practice Changes in Postoperative Feeding after Elective Colorectal Surgery: From Prospective Randomized Study to Everyday Practice

Am Surg. 2018 Oct 1;84(10):1675-1678.


Early postoperative feeding is the standard of care after colorectal surgery and is associated with improved outcomes. A controlled study performed at our center demonstrated faster bowel function recovery and shorter hospital stay without an increase in postoperative morbidity for a solid versus clear-liquid diet on postoperative day (POD) 1 after colorectal surgery. The present study aims to evaluate the impact of these findings on the practice of diet advancement by board-certified general surgeons (GS) and colorectal surgeons (CRS) at an urban teaching hospital. Patients undergoing elective colorectal surgery were prospectively evaluated. Data were compared with that of a study cohort that underwent elective colorectal surgery reported in 2012. Early postoperative feeding in the more recent cohort statistically increased for all cases on POD 0 and POD 1. Diet advancement over time revealed significant changes in early feeding on POD 0 for patients operated on by CRS (0% vs 83%; P < 0.0001) but not GS (13% vs 13%; P = 1). Patients operated on by either CRS or GS and offered early feeding on POD 1 did not significantly differ between time periods. Despite well-documented evidence of the advantages of early feeding, GS, but not CRS, remain reluctant to administer early diets to patients after colorectal surgery.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adolescent
  • Aged
  • Aged, 80 and over
  • Colon / surgery*
  • Diet
  • Elective Surgical Procedures / methods*
  • Elective Surgical Procedures / trends
  • Feeding Methods / trends*
  • Female
  • Hospitals, Teaching / statistics & numerical data
  • Hospitals, Urban / statistics & numerical data
  • Humans
  • Laparoscopy / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Postoperative Care / methods*
  • Practice Patterns, Physicians' / trends
  • Prospective Studies
  • Rectum / surgery*
  • Treatment Outcome
  • Young Adult