A randomized controlled trial comparing a standard postoperative diet with low‐volume high‐calorie oral supplements following colorectal surgery

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Abstract

Abstract Aim Postoperative oral nutritional supplementation is becoming a part of most patient care pathways. This study examined the effects of low‐volume high‐calorie prescribed supplemental nutrition on patient outcome following elective colorectal surgery. Method Patients undergoing elective colorectal resections were randomized to a prescribed nutritional supplementation group ( SG ) [standard diet + 6 × 60 ml/day of P ro‐ C al (60 ml = 200 kcal + 4 g protein)] or conventional postoperative diet group ( CG ) (standard diet alone). Preoperative and daily postoperative hand‐grip strengths were measured using a grip dynamometer after randomization. Daily food intake, return of bowel activity, nausea score for the first 3 days and postoperative length of hospital stay ( LOS ) were prospectively recorded. Micro‐diet standardized software was used to analyse food diaries. Nonparametric tests were used to analyse the data. Results Fifty‐five patients were analysed ( SG 28, CG 27). There was no difference in median preoperative and postoperative handgrip strengths at discharge within each group ( SG 31.7 vs 31.7 kPa, P = 0.932; CG 28 vs 28.1 kPa, P = 0.374). The total median daily calorie intake was higher in SG than CG ( SG 818.5 kcal vs CG 528 kcal; P = 0.002). There was no difference in median number of days to first bowel movement ( SG 3 days vs CG 4 days, P = 0.096). The median LOS was significantly shorter in SG than CG (6.5 vs 9 days; P = 0.037). Conclusion Prescribed postoperative high‐calorie, low‐volume oral supplements in addition to the normal dietary intake are associated with significantly better total daily oral calorie intake and may contribute to a reduced postoperative hospital stay.

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