Evidence of early oral feeding in colorectal surgery

There is much variability regarding time to start of enteral nutrition in patients undergoing colorectal surgery. In many instances such patients are postoperatively maintained with nasogastric intubation with the aim of preventing complications such as dehiscence, evisceration or eventration. We examine the clinical evidence regarding nasogastric tube placement and early feeding with reference to the PubMed, Embase, and Cochrane databases. Ia and Ib evidence was obtained from meta-analyses and prospective randomized studies, where the systematic use of a gastric decompression catheter is advised against and initiation of early feeding for colorectal surgery is recommended. Fasting does not provide any benefit after gastrointestinal surgery, and the use of nasogastric tubes does not decrease postoperative complications. However, less invasive surgery and new advances in anesthesia and analgesia are contributing to a reduction in postoperative ileus.