title: A randomized controlled trial comparing a standard postoperative diet with low-volume high-calorie oral supplements following colorectal surgery.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Patients undergoing elective colorectal resections were randomized to a prescribed nutritional supplementation group (SG) [standard diet + 6 × 60 ml/day of Pro-Cal (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).
  
  
  CONCLUSIONS
  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.
authors: Department of Colorectal Surgery, Newcastle Surgical Training Centre, Freeman Hospital NHS Trust, Newcastle Upon Tyne, UK.
authors: M
authors: M
authors: Sharma
authors: S
authors: S
authors: Wahed
authors: G
authors: G
authors: O'Dair
authors: L
authors: L
authors: Gemmell
authors: P
authors: P
authors: Hainsworth
authors: A F
authors: AF
authors: Horgan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000534:rehabilitation; D004035:Diet Therapy / Q000379:methods*; D019587:Dietary Supplements; D013505:Digestive System Surgical Procedures / Q000534:rehabilitation*; D002149:Energy Intake; D005260:Female; D018737:Hand Strength; D006801:Humans; D007902:Length of Stay; D008297:Male; D044342:Malnutrition / Q000517:prevention & control*; D008875:Middle Aged; D053581:Muscle Strength Dynamometer; D011182:Postoperative Care / Q000379:methods*; D012007:Rectum / Q000601:surgery; D016037:Single-Blind Method; D016896:Treatment Outcome; D055815:Young Adult
keywords: Nutrition; colorectal; recovery; supplements