Annals of Coloproctology

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ERAS

Tolerance to and postoperative outcomes with early oral feeding following elective bowel surgery: a systematic review with meta-analysis: Lord Mvoula, Evelyn Irizarry; Ann Coloproctol. 2024;40(6):538-547. Published online July 31, 2024; DOI: https://doi.org/10.3393/ac.2023.00472.0067

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Purpose
Advancements in gastrointestinal surgery have directed attention toward optimizing recovery, including through the use of feeding methods that reduce prolonged postoperative hospital stays, complications, and mortality, among other undesirable outcomes. This study’s primary goals were to identify current peer-reviewed literature reporting the postoperative outcomes of elective bowel surgery and to evaluate the clinical evidence of patients’ tolerance to oral feeding following elective bowel surgery.
Methods
An exhaustive literature search was conducted via PubMed and Scopus. The search results were screened for potential articles, and articles were assessed for eligibility based on prespecified eligibility criteria. The data were synthesized, and the results were reported and discussed thematically.
Results
The database search yielded 1,667 articles, from which 18 randomized controlled trials were chosen for inclusion in this study. This study included 874 early oral feeding (EOF) patients, 865 traditional oral feeding patients, and 91 patients whose postoperative care was unspecified. Data synthesis was done, and meta-analyses were conducted. The results showed that EOF patients required a significantly shorter time to tolerate a solid diet and had shorter hospital stays. In addition, bowel function was restored earlier in EOF groups.
Conclusion
The results show good tolerance to EOF, shorter hospitalizations, and faster restoration of bowel function, suggesting that EOF after elective bowel surgery is relatively safe. However, further studies with similar baseline conditions should be conducted to verify these results.

Citations

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An ERAS-Informed Pathway for Emergency Laparoscopic Repair of Gastroduodenal Perforation: A Pragmatic Pilot Randomized Trial
Zhangjun Wei, Rui Shen, Ping Che, Bo Huang
Indian Journal of Surgery.2026;[Epub] CrossRef
Outcomes of patients with cancer receiving early feeding following gastric, small intestinal or colorectal surgery
Thuy Tran, Bach Hoang, Tien Nguyen, Huong Le
World Academy of Sciences Journal.2025; 7(6): 1. CrossRef
Perioperative nutrition practices in gastrointestinal cancer surgery: A nationwide survey among German surgical departments
Rahel Maria Strobel, Katharina Beyer, Johannes Christian Lauscher, Marc Martignoni, Christoph Reißfelder, Tim Vilz, Arved Weimann, Maria Wobith
Langenbeck's Archives of Surgery.2025;[Epub] CrossRef

Original Articles

Patient-Controlled Nutrition After Abdominal Surgery: Novel Concept Contrary to Surgical Dogma: Hyung Ook Kim, Mingoo Kang, Sung Ryol Lee, Kyung Uk Jung, Hungdai Kim, Ho-Kyung Chun; Ann Coloproctol. 2018;34(5):253-258. Published online October 31, 2018; DOI: https://doi.org/10.3393/ac.2018.05.29

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4 Citations

Abstract PDF

Purpose
According to surgical dogma, patients who are recovering from general anesthesia after abdominal surgery should begin with a clear liquid diet, progress to a full liquid diet and then to a soft diet before taking regular meals. We propose patient-controlled nutrition (PCN), which is a novel concept in postoperative nutrition after abdominal surgery.
Methods
A retrospective pilot study was conducted to evaluate the feasibility and effects of PCN. This study was carried out with a total of 179 consecutive patients who underwent a laparoscopic appendectomy between August 2014 and July 2016. In the PCN group, diet was advanced depending on the choice of the patients themselves; in the traditional group, diet was progressively advanced to a full liquid or soft diet and then a regular diet as tolerated. The primary endpoints were time to tolerance of regular diet and postoperative hospital stay.
Results
Time to tolerance of a regular diet (P < 0.001) and postoperative hospital stay (P < 0.001) showed statistically significant differences between the groups. Multivariate analysis using linear regression showed that the traditional nutrition pattern was the only factor associated with postoperative hospital stay (P < 0.001). Multivariate analysis using logistic regression showed that traditional nutrition was the only risk factor associated with prolonged postoperative hospital stay (≥3 days).
Conclusion
After abdominal surgery, PCN may be a feasible and effective concept in postoperative nutrition. In our Early Recovery after Surgery program, our PCN concept may reduce the time to tolerance of a regular diet and shorten the postoperative hospital stay.

Citations

Citations to this article as recorded by

Robotic pancreatoduodenectomy in elderly individuals: An international multicenter propensity score–matched study by the PANFRAIL Collaborative group
Tiziana Marchese, Valentina Valle, Benedetto Ielpo, Marcello Giuseppe Spampinato, Annalisa Comandatore, Leonardo Borgioli, Pier Cristoforo Giulianotti, Luca Morelli, Matteo De Pastena, Alessandro Esposito, Roberto Salvia, Giuseppe Ietto, Roberto Delpini,
Surgery.2026; : 110153. CrossRef
Bilateral Exchange: Enteral Nutrition Clinical Decision Making in Pediatric Surgery Patients
Manisha B. Bhatia, Cassandra M. Anderson, Abdiwahab N. Hussein, Brian Opondo, Nereah Aruwa, Otieno Okumu, Sarah G. Fisher, Tasha Sparks Joplin, JoAnna L. Hunter-Squires, Brian W. Gray, Peter W. Saula
Journal of Surgical Research.2024; 295: 139. CrossRef
Clinical pharmacist intervention in Appendectomy - Dexmedetomidine as an adjunct therapy ‎
Bushra Abdel-Hadi, Sami Raid Abdel-Fattah
Journal Of Advanced Pharmacy Education And Research.2022; 12(2): 1. CrossRef
外科患者の栄養管理における給食の意義

The Japanese Journal of SURGICAL METABOLISM and NUTRITION.2021; 55(2): 57. CrossRef

Lifestyle Factors and Bowel Preparation for Screening Colonoscopy: Jong Hee Hyun, Sang Jin Kim, Jung Hun Park, Gyung Ah Wie, Jeong-seon Kim, Kyung Su Han, Byung Chang Kim, Chang Won Hong, Dae Kyung Sohn; Ann Coloproctol. 2018;34(4):197-205. Published online August 31, 2018; DOI: https://doi.org/10.3393/ac.2018.03.13

7,408 View
101 Download
6 Web of Science
6 Citations

Abstract PDF

Purpose
The quality of bowel preparation is a major determinant of the quality of colonoscopy. This study evaluated lifestyle factors, including usual dietary style, associated with bowel preparation.
Methods
This retrospective study evaluated 1,079 consecutive subjects who underwent complete colonoscopy from December 2012 to April 2014 at National Cancer Center of Korea. Questionnaires on bowel preparation were completed by the subjects, with the quality of bowel preparation categorized as optimal (excellent or good) or suboptimal (fair, poor or inadequate). Lifestyle factors associated with bowel preparation were analyzed.
Results
The 1,079 subjects included 680 male (63.0%) and 399 female patietns (37.0%), with a mean age of 49.6 ± 8.32 years. Bowel preparation was categorized as optimal in 657 subjects (60.9%) and as suboptimal in 422 (39.1%). Univariate analyses showed no differences between groups in lifestyle factors, such as regular exercise, alcohol intake, smoking, and dietary factor. Body mass index (BMI) > 25 kg/m² was the only factor associated with suboptimal bowel preparation on both the univariate (P = 0.007) and the multivariate (odds ratio, 1.437; 95% confidence interval, 1.104–1.871; P = 0.007) analyses.
Conclusion
Most lifestyle factors, including dietary patterns, exercise, alcohol intake and smoking, were not associated with suboptimal bowel preparation in Koreans. However, BMI > 25 kg/m² was independently associated with suboptimal bowel preparation. More intense preparation regimens before colonoscopy can be helpful in subjects with BMI > 25 kg/m².

Citations

Citations to this article as recorded by

Factors Affecting the Quality of Bowel Preparation Before Colonoscopy in Outpatient: A Prospective Observational Study
Shi Jun-li, Wang Lei, Ying Chun-ying, Fu Xin-zi, Li Bing-qing
Clinical Nursing Research.2023; 32(1): 149. CrossRef
Efficacy and tolerability of colonoscopies in overweight and obese patients: Results from a national database on gastrointestinal endoscopic outcomes
Monica Passi, Farial Rahman, Christopher Koh, Sheila Kumar
Endoscopy International Open.2022; 10(04): E311. CrossRef
Risk Factors for Suboptimal Bowel Preparation for Colonoscopy in Pediatric Patients
Pooja Reddy, Ali Mencin, Benjamin Lebwohl
Journal of Pediatric Gastroenterology and Nutrition.2021;[Epub] CrossRef
Risk Factors of Inadequate Bowel Preparation for Screening Colonoscopy
Efrat L. Amitay, Tobias Niedermaier, Anton Gies, Michael Hoffmeister, Hermann Brenner
Journal of Clinical Medicine.2021; 10(12): 2740. CrossRef
Novel sulfate tablet PBK‐1701TC versus oral sulfate solution for colon cleansing: A randomized phase 3 trial
Hyo‐Joon Yang, Dong Il Park, Soo‐Kyung Park, Chang Kyun Lee, Hyo Jong Kim, Shin Ju Oh, Jung Rock Moon, Beom Jae Lee, Jin Sung Koh, Hyun Soo Kim, Seon‐Young Park, Dong Hyun Kim, Jaeyoung Chun, Eun Ae Kang, Jung Kim, Hosim Soh, Chang Soo Eun, You Sun Kim, Y
Journal of Gastroenterology and Hepatology.2020; 35(1): 29. CrossRef
A Randomized Trial of Split Dose 3 L Polyethylene Glycol Lavage Solution, 2 L Polyethylene Glycol Lavage Combined With Castor Oil, and 1 L of Polyethylene Glycol Lavage Solution Combined With Castor Oil and Ascorbic Acid for Preparation for Colonoscopy
Xu Tian, Bing Shi, Xiao-Ling Liu, Hui Chen, Wei-Qing Chen
Frontiers in Medicine.2019;[Epub] CrossRef

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