Nutritional Timing in Pediatric Stoma Reversal: Early Versus Late Feeding Practices
DOI:
https://doi.org/10.54112/bcsrj.v6i9.2229Keywords:
Anastomosis, Surgical; Child; Enteral Nutrition; Intestinal Stomas; Postoperative ComplicationsAbstract
Early postoperative feeding after pediatric stoma reversal may enhance recovery, but concerns remain regarding its safety and association with postoperative complications. Objective: To determine the effect of early versus late feeding on postoperative complications among pediatric patients undergoing stoma reversal. Methods: This prospective cohort study was conducted in the Department of Pediatric Surgery, Liaquat University of Medical and Health Sciences, from 12 March 2025 to 12th June 2025. A total of 286 pediatric patients undergoing stoma reversal were enrolled and allocated into two groups according to the timing of postoperative oral or enteral feeding. Group E included 143 patients who commenced feeding within 24–48 hours after surgery, while Group L included 143 patients who started feeding after 48 hours. Intraoperative and postoperative outcomes were assessed, including return of bowel sounds, passage of stool, length of hospital stay, and postoperative complications. Continuous variables were expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. The chi-square test or Fisher’s exact test was used to compare postoperative complications between groups, with statistical significance set at p < 0.05. Results: The overall mean age of the patients was 6.32 ± 3.38 years, and most participants were female. Patients in the early feeding group showed significantly faster postoperative gastrointestinal recovery, with an earlier return of bowel sounds (2.22±1.06 vs 2.55±1.07 days; p=0.011) and earlier passage of bowel (3.11±1.33 vs 3.83±1.21 days; p=0.0005) compared with the late feeding group. Early feeding was also associated with a significantly shorter hospital stay (4.59±1.47 vs 6.55±1.84 days; p=0.0005). The frequency of postoperative complications, including fever, abdominal distension, anastomotic leakage, vomiting, and surgical site infection, did not differ significantly between the two groups. Conclusion: Early initiation of oral or enteral feeding within 24–48 hours after pediatric stoma reversal appears safe and is associated with faster gastrointestinal recovery and shorter hospital stay without increasing postoperative morbidity.
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