To eat or not to eat: Facilitating early oral intake after elective colonic surgery in the Netherlands

J. M. C. Maessen*, C. Hoff, K. Jottard, A. G. H. Kessels, A. J. Bremers, K. Havenga, R. J. Oostenbroek, M. F. von Meyenfeldt, C. H. C. Dejong, Dutch Breakthrough Project Periope

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    29 Citations (Scopus)

    Abstract

    Background & aims: It was shown that patients in the Netherlands remain exposed to unnecessarily Prolonged starvation after abdominal surgery. The present Study examined whether a structured collaborative effort Would help to implement the early Start Of Oral nutrition after colorectal Surgery.

    Methods: In 2006, twenty-six Dutch hospitals signed Lip to a "breakthrough project" concerning the implementation of the enhanced recovery after surgery (ERAS) programme with early oral feeding as one of the key elements. Each hospital determined the Usual Start of food intake by analyzing 50 patients who underwent a colorectal resection in 2004 (n = 1126). Subsequently, over the course of one year 861 colorectal surgery patients were treated according to the ERAS programme. The first day that patients were eating before and after the breakthrough project was compared using Kaplan-Meier analyses and Cox regression models.

    Results: Patients treated according to the ERAS programme were eating 3 days earlier than the patients traditionally treated (p <0.000). Two days after surgery 65% of the ERAS patients were eating normal food versus 7% of the pre-ERAS patients.

    Conclusions: The present nationwide collaborative effort was successful in implementing a change towards an early start of oral nutrition after abdominal surgery. (c) 2008 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All Fights reserved.

    Original languageEnglish
    Pages (from-to)29-33
    Number of pages5
    JournalClinical Nutrition
    Volume28
    Issue number1
    DOIs
    Publication statusPublished - Feb-2009

    Keywords

    • Abdominal surgery
    • Postoperative nutrition
    • Early oral nutrition
    • Breakthrough Series
    • Enhanced recovery after surgery
    • COLORECTAL SURGERY
    • ENFORCED MOBILIZATION
    • POSTOPERATIVE NAUSEA
    • PRACTICE GUIDELINES
    • BALANCED ANALGESIA
    • ENHANCED RECOVERY
    • CARE
    • RESECTION
    • IMPLEMENTATION
    • ANESTHESIA

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