title: The role of carbohydrate drinks in pre-operative nutrition for elective colorectal surgery.
abstract: BACKGROUND
  Traditionally, patients have been fasted from midnight on the night before elective surgery. With the advent of the enhanced recovery programme for elective colorectal surgery, there has been a major change in established practice with patients able to continue with clear  fluids up to two hours prior to surgery and solids up to six hours prior to surgery. It has been suggested that nutritional supplements in the immediate pre-operative period enhance post-operative recovery. The aim of this review was therefore critically to appraise the evidence available  regarding the use of pre-operative carbohydrate (CHO) supplements for elective colorectal surgery.
  
  
  METHODS
  A literature search was performed using: PubMed, MEDLINE(®), Athens and Google Scholar. The following keywords were used: 'pre-operative', 'carbohydrate supplements',  'enhanced recovery' and 'colorectal surgery', singly or in combination. To ensure an up-to-date literature search, the search was restricted to the last ten years. To maximise the search, backward chaining of reference lists from retrieved papers was also undertaken. Only English language  articles were included.
  
  
  CONCLUSIONS
  The use of CHO drinks pre-operatively in colorectal surgery is both safe and effective. There is no increased risk of aspiration and it results in a shorter hospital stay, a quicker return of bowel function and less loss of muscle mass. On the basis  of this evidence, the use of pre-operative CHO drinks should be standard in elective colorectal patients. Further research is nevertheless required for those with diabetes mellitus.
authors: Department of General Surgery, Daisy Hill Hospital, Newry BT35 8DR, UK. cjones82@hotmail.co.uk
authors: C
authors: C
authors: Jones
authors: S A
authors: SA
authors: Badger
authors: R
authors: R
authors: Hannon
mesh_terms: D001628:Beverages; D003107:Colorectal Surgery / Q000379:methods*; D004040:Dietary Carbohydrates / Q000008:administration & dosage*; D019587:Dietary Supplements; D017558:Elective Surgical Procedures / Q000379:methods*; D005215:Fasting; D006801:Humans; D011300:Preoperative Care / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
chemical_list: D004040:Dietary Carbohydrates