Early Versus Delayed Enteral Feeding After Emergency Laparotomy: Impact on Morbidity and Hospital Stay – A Prospective Study

Background: Emergency laparotomy is commonly performed for acute abdominal conditions and is associated with significant postoperative morbidity and prolonged hospital stay. Traditionally, enteral feeding is delayed to allow bowel recovery; however, recent evidence supports early enteral nutrition for improved outcomes. This prospective study, conducted over a year at a tertiary care center in North Gujarat, India, compared early (within 24 hours) versus delayed (48–72 hours) enteral feeding following emergency laparotomy. Adult patients with conditions such as perforation peritonitis, intestinal obstruction, and trauma were included, while those with severe comorbidities were excluded. The study aimed to assess postoperative morbidity and length of hospital stay. Material and Methods: This was a randomized controlled trial involving 120 patients divided equally into two groups: early enteral feeding (EEF) starting within 24 hours via nasogastric tube with gradual progression to oral intake, and delayed enteral feeding (DEF) initiated after return of bowel sounds (typically 48-72 hours). Inclusion criteria encompassed patients aged 18-65 years undergoing emergency laparotomy for non-malignant conditions. Exclusion criteria included preoperative malnutrition, mechanical ventilation >48 hours, or anastomotic concerns. Data collection involved daily monitoring for complications like wound infections, ileus, anastomotic leaks, and pneumonia. Statistical analysis used SPSS software, with chi-square tests for categorical variables and t-tests for continuous data; p