Impact of elemental diet on early recovery after laparoscopic colectomy: findings of a randomized controlled trial

• Published in: Surgery today (Tokyo, Japan) Vol. 47; no. 2; pp. 166 - 173
• Main Authors: Shichinohe, Toshiaki, Sasaki, Takeshi, Kitashiro, Shuji, Morita, Takayuki, Ono, Koichi, Senmaru, Naoto, Ikeda, Junichi, Kojima, Tetsufumi, Kyogoku, Noriaki, Yamada, Hidehisa, Sato, Nagato, Kato, Kentaro, Murakami, Soichi, Ebihara, Yuma, Kurashima, Yo, Tamoto, Eiji, Noji, Takehiro, Nakamura, Toru, Okamura, Keisuke, Tsuchikawa, Takahiro, Hirano, Satoshi
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.02.2017
• Subjects: Aged; Amino Acids - analysis; Colectomy - adverse effects; Colectomy - rehabilitation; Female; Food, Formulated - analysis; Humans; Laparoscopy - adverse effects; Laparoscopy - rehabilitation; Length of Stay; Malabsorption Syndromes - diet therapy; Malabsorption Syndromes - etiology; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Postoperative Complications - diet therapy; Postoperative Complications - etiology; Surgery; Surgical Oncology; Time Factors; Treatment Outcome; Laparoscopic colectomy; Estimated minimum length of stay in hospital after surgery; Elemental diet
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-016-1365-x

Purpose An amino acid-containing elemental diet (ED) does not require digestion for nutritional absorption, making it a good option for patients with gastrointestinal malabsorption. We conducted a randomized trial to confirm that perioperative ED enhanced the recovery of patients undergoing laparoscopic colectomy. Methods Patients in the intervention arm received commercially available ED from the day prior to surgery until postoperative day (POD) 3, whereas patients in the control group received a conventional perioperative diet program. To verify the endpoints, “estimated minimum length of stay in hospital after surgery” (emLOS) was defined as the number of days necessary to reach all the five criteria; namely, “sufficient oral intake”, “sufficient pain control”, “withdrawal of intravenous alimentation”, “no abnormal findings in routine examinations”, and “no rise in fever”. Results A total of 102 patients were randomized, 94 of whom were analyzed (ED 45, control 49). There was no morbidity or mortality. Shorter emLOS (POD 4 vs. POD 7; p  = 0.018), earlier resumption of sufficient oral intake (POD 3 vs. POD 4; p  = 0.034) and faster recovery to defecation (2.2 vs. 3.1 days; p  = 0.005) were observed in the ED group vs. the control group. Conclusions The perioperative ingestion of ED by patients undergoing laparoscopic colectomy is safe and can reduce the postoperative hospital stay by supporting the acceleration of oral intake.