Effect of early oral feeding on gastrointestinal motility in patients undergoing colorectal resection: a meta-analysis of randomized clinical trials

Zhi Jiang, Qi-Cheng Chen, Jun-Hong Zhang, Li-Xing Cao, Zhi-Qiang Chen


Background: The use of early oral feeding (EOF) to enhance the recovery of gastrointestinal (GI) motility after elective colorectal cancer surgery remains controversial. There was no updated meta-analysis to determine the efficacy and safety of this invention.
Methods: Randomized controlled trials (RCTs) were identified from PubMed, Embase, and the Cochrance Central Register of Controlled Trials (CENTRAL). Eleven RCTs (1,216 participants) were included in our meta-analysis.
Results: The EOF was associated with a shorter time of first flatus (MD =−0.58, 95% CI: −0.70 to −0.47, P<0.00001, I2 =19%), shorter first defecation (MD =−0.79, 95% CI: −1.00 to −0.59, P<0.00001, I2 =0%), and reduced length of hospital stay (MD =−1.48, 95% CI: −2.11 to −0.85, I2 =78%) compared to conventional oral feeding (COF). There was no significant difference between the EOF and COF group in the incidence of nausea, vomiting, nasogastric tube (NGT) reinsertion, the risk of wound infection, and the occurrence of pneumonia and anastomotic dehiscence. The risk of total postoperative complications was much lower in the EOF group than the COF group [relative risk (RR) 0.59, 95% CI: 0.48 to 0.73, I2 =46%, P<0.00001].
Conclusions: Our findings suggest that EOF is appropriate for patients after elective colorectal cancer surgery and it is good for the recovery of GI motility.