Editorial: Postoperative starvation after gastrointestinal surgery BMJ Volume 323, pp 761-2
There is no benefit in keeping patients "nil by mouth" (a period of starvation) after gastrointestinal surgery, suggests a study in this week's BMJ. These findings should challenge doctors to consider starting early feeding in these patients.
Eleven trials comparing enteral (tube) feeding within 24 hours after surgery with nil by mouth management were reviewed. Not only was there little evidence that keeping patients nil by mouth is beneficial after surgery, but early feeding reduced the risk of infection and shortened hospital stay.
These studies alone are insufficient to conclude that early feeding is of proved benefit, say the authors, but we believe that there is a good case for a high quality trial to confirm or refute the benefits of this treatment, they conclude.
These results provide compelling arguments in favour of a change in clinical practice, write two consultants at the Central Middlesex Hospital, in an accompanying editorial. They suggest that such a trial should also assess surgical fatigue, muscle function, quality of life after discharge from hospital, and cost effectiveness.