Influence of preoperative oral feeding on stress response after resection for colon cancer.
OBJECTIVE
Preoperative management involves patients fasting from midnight on the evening prior to surgery. Fasting period is often long enough to change the metabolic condition of the patient which increases perioperative stress response. That could have a detrimental effect on clinical outcome. The aim of the present study was to investigate the possible effects of carbohydrate-rich beverage on stress response after colon resection.


METHODS
Randomized and double blinded study included 40 patients with colon, upper rectal or rectosigmoid cancer. Investigated group received a carbohydrate-rich beverage the day before and two hours before surgery. In the control group patients were in the standard preoperative regime: nothing by mouth from the evening prior to operation. Peripheral blood was sampled 24h before surgery, at the day of the surgery, and 6, 24 and 48h postoperatively.


RESULTS
Colonic resection in both groups caused a significant increase in serum interleukin 6 (IL-6) levels 6, 24 and 48h after the operation. Increase was more evident and statistically significant in the group with fasting protocol. More significant increase of interleukin 10 (IL-10) occurred in patients who received preoperative nutrition.


CONCLUSIONS
Smaller increase in IL-6 and higher in IL- 10 are indicators of reduced perioperative stress.
Department of Abdominal Surgery, University Hospital Rijeka, Rijeka, Croatia. zelicm@medri.hr
Marko
M
Zelić
Davor
D
Stimac
Davor
D
Mendrila
Vlatka Sotošek
VS
Tokmadžić
Elizabeta
E
Fišić
Miljenko
M
Uravić
Alan
A
Sustić
D000368:Aged; D003110:Colonic Neoplasms / Q000601:surgery*; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D009325:Nausea / Q000209:etiology; D011183:Postoperative Complications / Q000097:blood* / Q000209:etiology; D011300:Preoperative Care; D012004:Rectal Neoplasms / Q000601:surgery*; D013312:Stress, Physiological / Q000187:drug effects*; D014839:Vomiting / Q000209:etiology
D004040:Dietary Carbohydrates; D015850:Interleukin-6; D016753:Interleukin-10