Early feeding after oncological colorectal surgery in Japanese patients

We aimed to determine the safety and feasibility of an alternative postoperative oral intake protocol for Japanese patients who had had oncological colorectal surgery, with the goal of shortening the length of postoperative stay to the same level as that in Western countries. The subjects of the study were 42 consecutive patients who underwent elective oncological colorectal surgery. Two protocols, Japanese traditional management (TM; n = 20) and alternative management (AM; n = 22), were employed. The two protocols differed in their management of oral intake after surgery. Tolerance of the alternative protocol and the incidence of postoperative complications were determined. The mean length of postoperative stay in the AM and TM groups was 11.5 +/- 1.2 and 24.0 +/- 2.1 days, respectively (P < 0.0001; t-test). Analysis of the patients who underwent open operation also revealed that the length of postoperative stay was less in the AM group than in the TM group (12.3 +/- 1.7 and 24.7 +/- 2.2 days, respectively, P = 0.0003). One patient in the TM group developed small bowel obstruction during the introduction of oral intake. One patient in the AM group also developed small bowel obstruction, after discharge, and was readmitted. Other patients tolerated both the TM and AM protocols. Morbidity in the AM group was 20.0%, and that in the TM group was 30.0% (P = 0.72). The employment of an alternative postoperative oral intake protocol was safe and feasible for Japanese patients. Further investigation is needed to determine the possible benefits, both medical and socioeconomic, of this approach.