Purpose: To compare the clinical outcomes of patients with and without early enteral nutrition after colorectal cancer surgery.
Methods: This is a retrospective comparative study using propensity score-matched cases. The study subjects were patients who received colorectal cancer resection surgeries during 2013 and 2018 in a Taiwan medical center. Data of the following variables were retrieved from subjects' medical records: age, sex, diagnosis, pathological stage, surgical approach, comorbidity, risk of malnutrition, anesthesia duration, enteral nutrition, time to the first postoperative flatus, time to the first defecation, feeding associated symptoms, nutrition interruptions, time to achieve nutrition goals, postoperative complications, the length of hospital stay. Subjects who received enteral nutrition within 48 h after the surgery were considered as the early enteral nutrition group.
Results: After propensity score matching, 227 subjects in each group were included in the final analysis. The early enteral nutrition group showed better results in the time to first postoperative flatus (mean difference: 0.96, 95% confidence interval: 1.16 ~ -0.76), the time to achieve nutrition goals (mean difference: 1.26, 95% confidence interval: 0.65 ~ -1.87), and the length of hospital stay (mean difference: 1.53, 95% confidence interval: 2.56 ~ -0.42), compared with the delayed enteral nutrition group. There were no between-group differences in the incidences of vomiting, distension, ileus, anastomosis leak, infection, re-operation, and interruptions of enteral nutrition.
Conclusions: Enteral feeding after colorectal cancer surgery can accelerate the recovery of gastrointestinal tract activities, promote nutrient intake, and shorten the length of hospital stay without increasing postoperative complications.
Keywords: Colorectal cancer; Early enteral nutrition; Length of hospital stay; Postoperative complications; Propensity score-matched analysis.
Copyright © 2021 Elsevier Ltd. All rights reserved.