الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Adequate nutrition has always been a major goal of postoperative care especially after abdominal surgery.
Post operative feeding is highly important to avoid electrolyte imbalance & restoe normal activities Traditionally, after abdominal surgery, the passage of flatus or bowel movements, which indicates the resolution of postoperative ileus, was the clinical evidence required for starting an oral diet. Studies have shown that the routine use of a nasogastric tube after elective abdominal surgery and colorectal surgery may not be necessary.
For most patients undergoing abdominal surgery, some degree of ileus exists for up to 3 to 6 days postoperatively. During resolution, there is a gradual return to normal bowel function and tolerance of oral nutrition Postoperatively, the bowel retains both electrical and muscular activity, but there is a lack of organized peristaltic activity, which causes varying degrees of dysmotility, functional obstruction and intolerance to oral intake. Postoperative ileus is most prominent in the colon. Normal motility returns to the stomach and small intestine within 12 to 24 hours after abdominal surgery, whereas normal colonic motility does not return until 48 to 72 hours postoperatively. In particular, the left colon is believed to be the slowest to regain normal activity There are several small series that have suggested that early feeding after abdominal operations may decrease the length of ileus.
In this study, it’s concluded that early feeding in elderly patients undergoing elective colon surgery resulted in shorter hospital stays with low morbidity. Overall, early feeding to reduce ileus has shown mixed results. It is now known that, in general, early feeding is safe after certain surgeries, although it is not necessarily effective in reducing the length of ileus. In fact, one randomized study showed that early feeding did not reduce the length of postoperative ileus. No difference has been observed when isosmolar or hyperosmolar diets, and elemental tube feeds do not appear to reduce the length of ileus. Cathartics such as magnesium citrate and oral contrast have been shown to hasten the return of bowel function, although the effect is not consistent and may not be related to the return of normal bowel motility.
This prospective study was carried out on 40 patients; all of them were subjected to elective colonic resection and anastmosis all of them ;groupcluded in this were inPatients 20 :)early feeding (The first groupreceived soft diet after audible intestinal sounds or passing.
The second group(regular feeding): 20 Patients, all of them were managed in traditional way, nothing by mouth until 5th postoperative day Patient preparation All of patients subjected to preoperative colon preparation which divided to:
Mechanical preparation & Chemical preparation Postoperative management: Patients are followed up via: Hospital stay, surgical complications, diet & bowel Function Our study has been conducted to evaluate the safety and tolerability outcomes of early oral feeding and to show the factors that affect early postoperative feeding after elective open abdominal colorectal procedures.
In our study, 15 patients (75%) tolerated early oral feeding while 5 patients (25%) failed to tolerate early feeding and presented with recurrent vomiting and abdominal distension without intestinal sound. In our study, the increased operative time and old age had a significant impact on tolerability of early oral feeding. Gender, type of operation and previous abdominal operation had no impact on the tolerability of early feeding. However, in our study 85% of patients tolerate traditional feeding without complication