Optimal recovery post gastrointestinal surgery : early versus delayed oral feeding

Abstract

Topic overview: Early oral feeding has a very prominent effect in enhancing surgical wound healing and general recovery, while decreasing length of stay and cost of hospitalization following gastrointestinal surgery. EOF is a new practice and research is still being carried out on this topic. This dissertation aims to identify what is known about this topic, its benefits, and complications. Research Question: Is early oral feeding following gastrointestinal surgery beneficial in promoting a faster recovery? PICO Elements: (P) Patients undergoing gastrointestinal surgery which received (I) early oral feeding were compared to those patients which received (C) traditional oral feeding and the (O) postoperative recovery was compared between these two groups. Inclusion criteria applied: Studies written in the English Language, published in the last five years, focus on gastrointestinal surgery on an adult population, meta-analysis and/or systematic reviews. Exclusion criteria applied: Studies written in other languages, have a different main focus or population, other study designs. Search Outcome: An overview of the databases used, the full search strategy, and the PRISMA checklist leading to the identification of the five key articles is presented. Method of appraisal used: The key articles were critically appraised using the Critical Appraisal Skills Programme (CASP) tools as a guideline. Main Results from the evidence: The studies presented inconsistent results due to various reasons including methodological differences and different types of Gastrointestinal surgeries. Although some studies presented statistical significance with increased recover and no increase in complications such as pneumonia and anastomotic leakage, other studies showed no statistical significance. Main conclusion: Although the promising benefits of EOF are presented, this conclusion is not definite and further studies are necessary. Implications and most important recommendations: Recommendations include further well-designed clinical trials to determine the efficacy of EOF. Local implementations require education to healthcare professionals about EOF, the delivery of the safest practice, and creating local guidelines following EBP.