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Evidence summaries

Early Versus Later Commencement of Feeding after Colorectal Surgery

Early commencement of enteral feeding may be at least as safe as enteral feeding delayed for more than 24 hours. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 14 studies with a total of 1 224 subjects. Individual clinical complications failed to reach statistical significance, but the direction of effect indicates that earlier feeding may reduce the risk of post surgical complications. Mortality was the only outcome showing a significant benefit (RR 0.41, 95% CI 0.18 to 0.93), but not necessarily associated with early commencement of feeding, as most commonly reported cause of death was anastomotic leakage, reoperation, and acute myocardial infarction.

Comment: The quality of evidence is downgraded by imprecise results (limited study size for each comparison) and by limitations in study quality.

    References

    • Andersen HK, Lewis SJ, Thomas S. Early enteral nutrition within 24h of colorectal surgery versus later commencement of feeding for postoperative complications. Cochrane Database Syst Rev 2006 Oct 18;(4):CD004080 [Review content assessed as up-to-date: 9 January 2011]. [PubMed]

Primary/Secondary Keywords