Running Title: Effects of Preoperative Oral Carbohydrate-rich Solution = Running Title: Effects of Preoperative Oral Carbohydrate-rich Solution

다국어 초록 (Multilingual Abstract)

Background: Bowel preparation in elective colon surgery typically requires two days of diet restriction and administration of laxatives. However, studies now show that this may no longer be a strict protocol for colorectal surgery. Aside from patients experiencing the discomfort of NPO, there are reported benefits regarding intake of liquids until at least two hours prior to surgery such as decrease in insulin resistance, without additional postoperative surgical complications.
Purpose: This study aims to show the benefits of oral rehydration solution administration two hours prior to surgery for patients undergoing elective colectomy, particularly postoperative insulin resistance.
Methods: This is a randomized controlled trial. All patients undergoing elective colectomy is included and randomized to the control arm or treatment arm. The control arm consists of the standard bowel preparation and one day of NPO, while the treatment arm consists of the standard bowel preparation and allowing carbohydrate-rich oral rehydration solution intake until 2 hours before surgery. The insulin, glucose, cortisol and triglyceride levels is determined right after induction, 6 hours, 24 hours, and 48 hours post-op, and compared. The Homeostatic Model Assessment - Insulin Resistance (HOMA-IR), insulin, glucose, cortisol, and triglyceride levels will be determined and compared between the two groups. Also, pre- and postoperative satisfactions of patients were assessed using questionnaires.
Results: Total number of enrolled patients was 77. Of 77 patients, 4 patients have retrieved previous consent and operation schedules of two patients were cancelled. Of 71 patients, samples of ten patients were analyzed incompletely. There was time effect on both groups. However, there was no significant in the difference of HOMA-IR according to groups and time (Repeated-Measure ANOVA) although the graph looked like showing some differences (p=0.516). Cortisol and TG were also not significant, respectively (p=0.706, p=0.241). Patients who had drunk ORS preoperatively have satisfied (p<0.001)
Conclusions: Preoperative oral carbohydrate-rich solution had a limited effect on postoperative Insulin-resistance in patients undergoing colectomy. Satisfaction was higher in patients group who had drunk ORS preoperatively.