Delayed postoperative diet is associated with a greater incidence of prolonged postoperative ileus and longer stay in hospital for patients undergoing gastrointestinal surgery

AIM: Recent evidence favours a move away from delaying postoperative nutrition towards early feeding practices for better patient outcomes after gastrointestinal surgery. The aim of the present study was to investigate postoperative diet progression and patient outcomes in a secondary hospital with a view to inform future practice. METHODS: This was a retrospective study of gastrointestinal surgery patients (n = 69) at a Western Australian general hospital. Demographic data and outcomes were collected from patient records and included presence or absence of prolonged postoperative ileus, length of stay in hospital, days on minimal nutrition and days until first flatus or stool. RESULTS: A significant positive association was observed between number of days a patient remained on minimal nutrition and length of stay in the overall group (r = 0.66, P < 0.01). Patients who developed prolonged postoperative ileus (n = 18, 26%) had a greater number of days on minimal nutrition (20.0 vs 8.0 days, P < 0.01), longer stay in hospital (15.0 vs 8.0 days, P < 0.01) and increased number of days to first flatus or stool (4.0 vs 2.4 days, P < 0.01) compared with those who did not develop prolonged postoperative ileus (n = 51, 74%). CONCLUSIONS: This retrospective study of current practice in a secondary-care general hospital highlights the gap between traditional care and the improved outcomes reported in the literature when early feeding practices are adopted after GI surgery. Further investigation of barriers and enablers is necessary to provide insight into developing the most appropriate strategy to achieve this.