A Prospective Comparative study of Early Versus Late Enteral Feeding After Major Gastrointestinal Surgeries

BACKGROUND: As per routine protocol, patients undergoing major gastrointestinal surgeries are kept nil by mouth till intestine starts functioning. But evidence from clinical studies suggests that initiating enteral feeding early is beneficial and advantageous to patient and reverses mucosal atrophy induced by starvation and also increases collagen deposition at the surgical sites, promoting wound healing. Finally, early enteral feeding may also reduce septic morbidity and improves postoperative outcome. OBJECTIVES: This study was conducted to compare the feasibility, safety, efficacy, tolerability and outcome of early enteral feeding versus late oral feeding after elective and emergency gastrointestinal surgeries. MATERIALS AND METHODS: The prospective comparative study included 50 cases of major gastrointestinal surgeries operated at Coimbatore Medical College Hospital from January 2018 to June 2019, from which randomly 25 patients were selected for conventional nil by mouth approach and rest of 25 patients were given early enteral feeding within 1st 24 hours post operatively. RESULTS: In the study most common age group, who undergone surgery in both case and control groups was between 30-60 years with male predominance in both groups. Most common surgery performed was perforation closure in both groups. The study group had statistically significant low rate of wound infection, wound dehiscence, paralytic ileus, leak, GI Complications and post operative pain with less hospital stay. CONCLUSION: Compare to conventional nil by mouth approach, early enteral feeding significantly reduces the incidence of wound infection, paralytic ileus and pain in post operative patients undergoing major gastrointestinal surgeries, thereby reducing length of hospital stay, which suggest that early enteral feeding is safe, effective and feasible in post operative patients of major gastrointestinal surgeries