Overnight fasting before surgery used to be the routine. Overnight fasting changes patients’ metabolic state and influences their perioperative stress response. The aim of the study was to investigate the effects of preoperative carbohydrate drinks on return of bowel sounds and movement, postoperative complications, and length of stay.
It is a prospective non-randomized study with 196 consecutive patients who underwent surgery in Vsetin hospital for a diagnosis of colon or rectal cancer from January 2010 to January 2015. Patients were assigned into two groups – with (PreOp group) and without (Non-PreOp group) carbohydrate drink. We collected data regarding age, comorbidities, local stage of tumor, urgency and type of operation. The output variables recorded included postoperative bowel sounds, first stool, postoperative complications, anastomotic leak, surgical site infections, and length of hospital stay.
In the PreOp group there was faster return of peristalsis (p = 0,033). We did not prove that the PreOp influenced passage of stool. The total number of postoperative complications was higher in the Non-PreOp group than in the PreOp group, 57 (57%) vs. 30 (31%) respectively, (p = 0,0003). The most frequent type of complication was surgical site infection (SSI). It occurred in 17% in the PreOp group and in 34% in the Non-PreOp group (p = 0,004). The difference in anastomotic leak rate was not significant. Mean hospital stay was 13 days in the PreOp group and 16 days in the Non-PreOp group (p = 0,006).
Use of carbohydrate solution before the surgery accelerates return of bowel sounds, reduces total number of postoperative complications, SSI and shortens the length of hospital stay. Carbohydrate beverages should be used more widely in daily practice.