[Early postoperative nutrition after laparoscopic and open colorectal resection]

Abstract

Background: Discussions concerning postoperative nutrition were brought up again with laparoscopic colorectal surgery. We are looking whether there is any difference between open and minimal invasive procedures with respect to the start of oral intake.

Methods: In a prospective controlled trial 152 patients were analysed after laparoscopic (n = 85) or open (n = 67) colorectal resections. At the first postoperative day fluid intake was unlimited and from the second day regular food was permitted according to the patients desire.

Results: No influence on the beginning of nutrition was by age, diagnoses, type of operation nor their duration. Wound infection and specially cardiopulmonal decompensation prolonged lack of appetite, however, not a pneumonia. There was no increase of anastomotic leak rate. At day 4, a highly significant difference was found between laparoscopic and open surgery with 90% and 60% of patients having started regular nutrition (p < 0.001).

Conclusion: Early postoperative oral nutrition does not increase complication rate. Patients after laparoscopic procedures start earlier eating compared with those after conventional surgery. We recommend early postoperative oral intake after both techniques according to the patients desire.