Abstract

Objective: The aim of this prospective study was to evaluate the safety of preoperative amino acid plus CHO drink (Elental®) loading in colon cancer surgery. Summary of Background Data: Prolonged preoperative fasting increases insulin resistance and current evidence recommends carbohydrate drinks 2 hours before surgery. Methods: We prospectively enrolled consecutive patients with a preoperative diagnosis of colon cancer who underwent surgery. The patients received 600 ml of Elental® the night before surgery and 300 ml of Elental® 3 h prior to induction of anaesthesia. Primary endpoint was the safety of preoperative amino acid (Elental®) loading in colon cancer surgery. Safety measurement was anastomotic leakage and aspiration pneumonia. Secondary endpoints were incidence rate of incisional surgical site infection, recovery of bowel movement, length of hospital stay, postoperative nutritional status and insulin resistance. Results: A total of 80 consecutive patients were enrolled in this study from February 2013 to January 2014. The incidence of anastomotic leakage was 3 cases (3.8%) and there were no aspiration pneumonia. The incidence of incisional surgical site infection was 2 cases (2.5%). The median time of first flatus, defecation after surgery and postoperative hospital stay was 1 day, 2 days and 6 days. The insulin resistance recovered to a preoperative level after 3 days after surgery. Conclusion: The preoperative amino acid plus CHO drink (Elental®) loading 3h prior to induction of anaesthesia in colon cancer surgery is safe and incisional surgical site infection rate and recovery of bowel movement and insulin resistance are feasible.

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