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Who tolerates early enteral feeding after colorectal surgery?

Divya Naresh, John Kefalianos, David Watters, Douglas Stupart · ANZ Journal of Surgery · 2020

AbstractBackgroundEarly enteral feeding and avoidance of routine nasogastric tube (NGT) placement have become standard care following colorectal surgery. However, some patients require NGT decompression post‐operatively for vomiting or distension.MethodsThis was a retrospective cohort study of all patients undergoing elective intra‐abdominal colorectal surgery at University Hospital, Geelong, from 2014 to 2018. Failure of early feeding was defined by the placement of an NGT post‐operatively, beyond the day of surgery.ResultsA total of 754 patients were identified. Of these, 28 were excluded due to protocol violations (NGT was left in situ at the end of the operation), leaving 726 patients that were included in the analysis. Overall, 156/726 (21%) patients failed early feeding. The strongest independent predictor of failure was undergoing a total or subtotal colectomy compared with all other operations (15/28 (54%) failed versus 141/698 (20%); P < 0.001). Laparoscopic surgery was independently associated with a lower risk of failure compared with open surgery (43/278 (15%) versus 113/448 (25%); P = 0.002). Risk of failure was not associated with gender, age, American Society of A

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