SAFETY OF EARLY VERSUS DELAYED ENTERAL FEEDING FOLLOWING ILEOSTOMY CLOSURE: RANDOMIZED CONTROLLED TRIAL

Abstract

Objective: to compare the safety of early versus late enteral feeding in terms of tolerability and leak following Ileostomy closure. Methodology: This prospective randomized trial was conducted at Lady Reading Hospital Peshawar from January 2010 to December 2011 on 60 patients, hospitalized for temporary ileostomy after fulfilling the inclusion and exclusion criteria. The patients were allocated into two groups of 30 each by simple random technique. Group A were allowed oral feeds in the early postoperative period (within 24 hours after surgery). Group B who were postoperatively kept “nil by mouth“ up to 72 hours. All patients were followed up on day 7th and 14th after surgery. Post-Operative complications like intra-abdominal collection, leak/ fistula and any mortality were diagnosed on the basis of clinical examination, ultrasound and C.T Scan abdomen. Data were compiled and analyzed with SPSS 16. Result: The age of the patients ranged from 21-79 years with the mean age for early oral feeding was 42±13 years and for delayed oral feeding was 44±15 years. The male to female ratio for early feeding was 4:1 and for delayed feeding 2.3:1. Early oral feeding was well tolerated in 83.3% cases while in late oral feeding 90% which was statistically insignificant with P-value=0.7065. In this study no leak, fistula or death was documented in either group. Conclusion: Early postoperative oral feeding after ileostomy closure is safe, well tolerated and the fear related with its failure do not have solid grounds and it should be encouraged in elective cases.