Efficacy of the Oral Administration of Maltodextrin Fructose Before Major Abdominal Surgery: A Prospective, Multicenter Clinical Study

• Published in: World journal of surgery 2022-09, Vol.46 (9), p.2132-2140
• Main Authors: Qin, Huanlong, Ji, Jiafu, Miao, Yi, Liu, Tong, Zhao, Dongbing, Jia, Zhenyi, Jiang, Jun, Liu, Jiang, Li, Qiang, Ji, Xi, Fu, Weihua, Lou, Donghua, Xia, Wenyu, Li, Ning
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Appetite; Blood; Blood glucose; Cardiac Surgery; Clinical trials; Fasting; Fructose; Gastrectomy; General Surgery; Glucose; Immunoglobulins; Insulin; Insulin resistance; Insulin secretion; Laboratory testing; Maltodextrin; Medicine; Medicine & Public Health; Nausea; Oral administration; Original Scientific Report; Psychological factors; Surgery; Thoracic Surgery; Vascular Surgery; Well being
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-022-06455-7

Background To study the efficacy of the oral administration of maltodextrin and fructose before major abdominal surgery (MAS). Methods This prospective, multicenter, parallel-controlled, double-blind study included patients aged 45–70 years who underwent elective gastrectomy, colorectal resection, or duodenopancreatectomy. The intervention group (IG) was given 800 mL and 400 mL of a maltodextrin and fructose beverage at 10 h and 2 h before MAS, respectively, and the control group (CG) received water under the same experimental conditions. The primary endpoint was insulin resistance index (IRI), and the secondary endpoints were fasting blood glucose, fasting insulin, insulin secretion index, insulin sensitivity index, intraoperative blood glucose, subjective comfort score, and clinical outcome indicators. Results A total of 240 cases were screened, of which 231 cases were randomly divided into two groups: 114 in the IG and 117 in the CG. No time-treatment effect was detected for any endpoint. The IRI and fasting insulin were significantly lower in the IG than CG after MAS ( p  = 0.02 & P  = 0.03). The scores for anxiety, appetite, and nausea were significantly lower in the IG than CG at 1 h before MAS. Compared with baseline, the scores for appetite and nausea decreased in the IG but increased in the CG. Conclusion The oral administration of maltodextrin and fructose before MAS can improve preoperative subjective well-being and reduce postoperative insulin resistance without increasing the risk of gastrointestinal discomfort.