Effect of water-soluble contrast in colorectal surgery: a prospective randomized trial.
OBJECTIVE
Postoperative gastrointestinal-tract motility is normally delayed. Early feeding after colorectal surgery has been reported recently, but late feeding is common. Gastrografin not only enhances bowel peristalsis, but also decreases bowel-wall edema. Whether contrast medium allows early oral feeding and reduces the duration of hospitalization requires clarification.


METHODS
Fifty patients underwent elective colorectal surgery in a regional medical center. Patients were prospectively randomized into a Gastrografin group or control group (n = 25 each). Patients in the Gastrografin group began their feeding schedule with 100 mL of 5% dextrose water with 100 mL of Gastrografin on postoperative d 3 and were advanced to a full liquid diet when the contrast reached the colon in 4 h. Patients in the control group began their feeding schedule with 200 mL of 5% dextrose water on postoperative d 3 and were advanced to a full liquid diet after the passage of flatus and stool. Nasogastric tubes were inserted for persistent postoperative vomiting. Fullness, nausea, vomiting, complications, time of anesthesia, time of operation, time of mobilization, time of oral feeding, and duration of hospital stay were recorded and analyzed with Student's t-test.


RESULTS
In the Gastrografin group, one patient had aspiration pneumonia and one patient had anastomotic leakage resulting in sepsis and eventual death. This mortality was excluded from the subsequent statistical analysis. In the control group, two patients had wound infections. There was no significant difference between the two groups at the time of anesthesia, time of operation, or time of mobilization. There were significant differences between the two groups in the time of oral feeding (3.3+/-0.3 d in the Gastrografin group vs 4.8+/-0.4 d in the control group; P = odds ratio--, 95%CI [-0.5 to +0.7 d]) and in the length of hospital stay (7.6+/-1.1 d in the Gastrografin group vs 10.2+/-1.3 d in the control group; P = odds ratio--, 95% CI [-1.2 to +1.4 d]).


CONCLUSIONS
Gastrografin not only allowed early oral feeding but also reduced the duration of hospitalization after elective colorectal surgery.
Chen
Jia-Hui
JH
Division of General Surgery, Tri-Service General Hospital, #325 Sec. 2 Chen-Kung Road, Neihu 114, Taipei, Taiwan, China.
Hsieh
Chung-Bao
CB
Chao
Pei-Chieh
PC
Liu
Hsiao-Dung
HD
Chen
Chung-Jueng
CJ
Liu
Yao-Chi
YC
Yu
Jyh-Cherng
JC
D000368:Aged; D000369:Aged, 80 and over; D003107:Colorectal Surgery; D003287:Contrast Media / Q000737:chemistry; D003974:Diatrizoate Meglumine / Q000737:chemistry; D004435:Eating; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D011184:Postoperative Period; D012995:Solubility; D013997:Time Factors; D014867:Water
D003287:Contrast Media; D014867:Water; D003974:Diatrizoate Meglumine