title: Prospective randomized trial of early initiation and hospital discharge on a liquid diet following elective intestinal surgery.
abstract: Length of hospital stay after elective intestinal surgery may be related to patient tolerance of a diet. We hypothesized that early initiation and discharge home on a clear liquid diet would decrease the length of hospital stay without increasing morbidity. The aim of this study was to determine if early initiation and discharge on a clear liquid diet decreases the length of hospital stay and is safe. Forty-four patients were randomly assigned to either a standard diet or a clear liquid diet. A standard diet (n = 17) was begun after the passage of flatus or stool, and consisted of clear liquids to a volume of approximately 750 ml, then three solid meals, and discharge thereafter. Patients randomized to a clear liquid diet (n = 27) received 30 ml/hr of clear liquids on postoperative day 2, unlimited clear liquids on postoperative day 3, and were dismissed on a clear liquid diet on postoperative day 4. All patients were followed by a daily telephone call and clinic visit. The primary outcome variable was length of hospital stay. The incidence of postoperative intestinal-related sequelae, complications, and readmission rates did not differ between groups. Postdischarge intestinal symptoms were common in both groups but tended to resolve faster in the patients on a standard diet. The length of hospital stay was decreased in the patients on a clear liquid diet compared to those on a standard diet (6.1 +/- 1.1 days vs. 4.4 +/- 0.2 days; P = 0.09), but total hospital costs did not differ. Early initiation and hospital discharge on a clear liquid diet after elective intestinal surgery decreases the length of hospital stay and is safe.
authors.affiliation: Section of Gastrointestinal Surgery, Department of Surgery, University of North Carolina, Chapel Hill, NC 27599-7210, USA. KevinBehrns@med.unc.edu
authors.forename: K E
authors.initials: KE
authors.lastname: Behrns
authors.forename: A P
authors.initials: AP
authors.lastname: Kircher
authors.forename: J A
authors.initials: JA
authors.lastname: Galanko
authors.forename: M R
authors.initials: MR
authors.lastname: Brownstein
authors.forename: M J
authors.initials: MJ
authors.lastname: Koruda
mesh_terms: D004032:Diet; D017558:Elective Surgical Procedures; D005260:Female; D005767:Gastrointestinal Diseases / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D011182:Postoperative Care / Q000191:economics*; D011446:Prospective Studies