The comparative study of the outcomes of early and late oral feeding in intestinal anastomosis surgeries in children

Abstract

Background: A leakage of intestinal anastomosis is typically regarded as a devastating post-operative complication. Traditionally its believed that long fasting after intestinal surgery protect anastomosis site and most surgeons applied this method. Post-operative long fasting has many physical and   mental adverse effects, especially in children, but its benefi t has not
proven yet. This study aimed to compare the outcomes of early and late oral feeding in intestinal resection and anastomosis surgery in children. Patients and Methods: This randomized, double-blind controlled trial evaluated the outcome of early-feeding following in children aged 1 month to 12 years who underwent intestinal resection and anastomosis and  compared the results with those who had late-feeding. The results were anlysed for fever, nausea and vomiting, abdominal distension, first  passage of gas and stool were also evaluated hospital stay time, major post-operative complications such as anastomosis leakage, wound infection or dehiscence, intra-abdominal abscess between the two groups. Results: The mean time of first oral feeding in the early feeding group (study group) was 2.5 ± 0.7 days but it was 5.3 ± 0.6 days in the late feeding group (control group). There was no mortality in both groups. There was no difference in major complications in both groups  (anastomosis leakage). In the study group, fi rst defecation time was
shorter than the control group (3.7 days v. 4.4 days) and they had less hospital stay also (5.2 days vs. 8.3 days) and lower cost of hospitalization. Conclusion: Early oral feeding after intestinal resection and anastomosis
in children is a safe method, it has many benefits and does not increase  the major or minor post-operative complications (anastomosis leakage) long time fasting is not necessary and has not any benefi cial effect and
early feeding increases satisfaction of the parents and children, and reduce hospital stay and costs.

Key words: Children, early feeding, intestinal anastomosis, late feeding