Preoperative low-residue diet in gynecological surgery

• Published in: European journal of obstetrics & gynecology and reproductive biology 2022-04, Vol.271, p.172-176
• Main Authors: Palaia, Innocenza, Di Donato, Violante, Caruso, Giuseppe, Vestri, Annarita, Scudo, Maria, Alunni Fegatelli, Danilo, Galli, Valerio, Cavalli, Alessandra, Perniola, Giorgia, Benedetti Panici, Pierluigi, Muzii, Ludovico
• Format: Article
• Language: English
• Subjects: ERAS; Gynecology; Low-residue diet; Perioperative management; Surgery
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2022.02.018

•The benefit of mechanical bowel preparation before gynecologic surgery is unclear.•Preoperative low-residue diet is well-tolerated.•Preoperative low-residue diet may improve the surgical field quality.•Preoperative low-residue diet may reduce postoperative ileus. To evaluate the impact of preoperative low-residue diet on intra- and postoperative outcomes among gynecological surgical patients. This is a surgeon-blind, randomized controlled trial enrolling patients undergoing elective surgery for either benign disease or endometrial carcinoma. Patients were preoperatively randomized to receive either low-residue diet (arm A) or free diet (arm B) starting from three days before surgery. The primary outcome was the quality of the surgical field (scored using a 5-point scale, from poor to excellent). Secondary outcomes were postoperative pain (assessed through VAS scale), postoperative complications, operative time, time to first passage of flatus, length of hospital stay. Perioperative data were collected and compared between groups. A total of 96 patients were enrolled and randomized in arm A (n = 49; 51%) and arm B (n = 47; 49%). The mean age was 47.8 ± 15.6 years in arm A and 48.1 ± 11.3 years in arm B. Endometrial cancer patients were 16.3% in arm A and 10.6% in arm B, and patients with benign disease were 83.7% and 89.4%, respectively. The surgical evaluation of the small intestine was scored