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Paper Information

Journal:   JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)   Spring 2002 , Volume 19 , Number 61; Page(s) 61 To 64.



After Appendectomy like other abdominal surgeries, patients are traditionally fed when postoperative ileus resolves. The aim of this study was to assess the safety and tolerability of early oral feeding after appendectomy that would lead to a shorter duration of hospitalization.
Two hundreds young patients (range 15-45 years) with uncomplicated appendicitis (without phlegmon, Abscess or peritonitis) between January 2000 and August 2000 in Isfahan (AL- Zahra and Kashani Hospitals) were randomized for this clinical trial: 100for early feeding (EF) protocol consisting of clear liquid diet starting at the sixth postoperative hour, then advancing to regular diet in the subsequent six hours and discharging home as tolerated at the 12th postoperative hour, and 100 patients in traditional feeding (TF) group in which the feeding was started after resolution of post- operative ileus. Both groups were similar in type of anesthesia and procedure and postoperative analgesia and were checked for vomiting - abdominal pain or distention and length of hospitalization. The feeding was discontinued if three or more episodes of vomiting of more than 100 mililiters occured.
No significant difference was seen in rate of food tolerance (99% in EF- group and 100% in TF- group). (P>0.05) Ten in EF group (10%) and 5 in TF group (5%) developed 2 episodes of vomiting that did not lead to discontinuation of feeding except one in EF group who developed more than 2 episodes of vomiting after starting of diet. Non of the patients in both groups developed complication. The average postoperative hospital stay was 17.6 ± 6.4 hours (range 10-42 hours) in EF- group versus 46:t16.9 hours (range 21-100 hours) in TE group.
Neither group had readmission for recurrent nausea or vomiting. Too early postoperative oral feeding after uncomplicated appendicitis is safe and can be tolerated by the majority of patients and significantly reduces post operative hospital stay.

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