Original Research
Gynecology
Effects of coffee consumption on gut recovery after surgery of gynecological cancer patients: a randomized controlled trial

https://doi.org/10.1016/j.ajog.2016.10.019Get rights and content

Background

Paralytic ileus that develops after elective surgery is a common and uncomfortable complication and is considered inevitable after an intraperitoneal operation.

Objective

The purpose of this study was to investigate whether coffee consumption accelerates the recovery of bowel function after complete staging surgery of gynecologic cancers.

Study Design

In this randomized controlled trial, 114 patients were allocated preoperatively to either postoperative coffee consumption with 3 times daily (n=58) or routine postoperative care without coffee consumption (n=56). Total abdominal hysterectomy and bilateral salpingo-oophorectomy with systematic pelvic and paraaortic lymphadenectomy were performed on all patients as part of complete staging surgery for endometrial, ovarian, cervical, or tubal cancer. The primary outcome measure was the time to the first passage of flatus after surgery. Secondary outcomes were the time to first defecation, time to first bowel movement, and time to tolerance of a solid diet.

Results

The mean time to flatus (30.2±8.0 vs 40.2±12.1 hours; P<.001), mean time to defecation (43.1±9.4 vs 58.5±17.0 hours; P<.001), and mean time to the ability to tolerate food (3.4±1.2 vs 4.7±1.6 days; P<.001) were reduced significantly in patients who consumed coffee compared with control subjects. Mild ileus symptoms were observed in 17 patients (30.4%) in the control group compared with 6 patients (10.3%) in the coffee group (P=.01). Coffee consumption was well-tolerated and well-accepted by patients, and no intervention-related side-effects were observed.

Conclusion

Coffee consumption after total abdominal hysterectomy and systematic paraaortic lymphadenectomy expedites the time to bowel motility and the ability to tolerate food. This simple, cheap, and well-tolerated treatment should be added as an adjunct to the postoperative care of gynecologic oncology patients.

Section snippets

Materials and Methods

This randomized controlled study was conducted at the Tepecik Education and Research Hospital, Department of Gynecological Oncology, Izmir, Turkey, between November 2013 and February 2016. Ethical approval was obtained from the Istanbul Kanuni Sultan Suleyman Education and Research Hospital Ethics Committee (reference number: 10/2013). Additionally, the study was registered with clinicaltrials.gov (no. NCT01990482).

Patients who had received a diagnosis of cervical, endometrial, or ovarian

Results

During the study period, in total, 118 patients were enrolled; 60 patients were assigned randomly to the coffee group, and 58 were assigned to the control group. Four patients (2 in the control group and 2 in the treatment group) were excluded after randomization because they no longer fulfilled the inclusion criteria. Ultimately, the conditions of 56 patients in the control group and 58 in the coffee group were analyzed. The reasons for exclusion before and after randomization are shown in the

Comment

This randomized trial showed that coffee consumption during the early postoperative period after abdominal hysterectomy and systematic PPL shortened the time to bowel motility and the ability to tolerate food. Moreover, a regression model showed that coffee consumption after surgery was independently protective against the development of POPI. It has a low cost, compared with pharmacologic management to prevent ileus (such as opioid receptor antagonists, ghrelin receptor agonists, and serotonin

Acknowledgments

We gratefully acknowledge the investigators, their coinvestigators and study coordinators, and the patients who participated in this trial.

References (23)

  • D.E. Beck et al.

    Prospective, randomized, controlled, proof-of-concept study of the Ghrelin mimetic ipamorelin for the management of postoperative ileus in bowel resection patients

    Int J Colorectal Dis

    (2014)
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      Citation Excerpt :

      Exorphins are found in regular and decaffeinated coffee [10,11], and coffee stimulates motor activity in the colon by antagonizing adenosine receptors [12]. Güngördük et al. [13] conducted a randomized, controlled trial (RCT) of coffee consumption after laparotomy with hysterectomy and staging in 114 women with gynecologic malignancies. To date, this is the only investigation of the effectiveness of coffee consumption for the prevention of POI after gynecologic oncology surgery.

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    The authors report no conflict of interest.

    Cite this article as: Güngördük K, Özdemir İA, Güngördük Ö, et al. Effects of coffee consumption on gut recovery after surgery of gynecological cancer patients: a randomized controlled trial. Am J Obstet Gynecol 2017;216:145.e1-7.

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