Clinical nutrition (Edinburgh, Scotland) · 2026
Clinical and Metabolic Effects of Preoperative Carbohydrate Loading Before Colorectal Surgery: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Pivetta Henrique B, Massoud Rodrigo O, Filho Marcílio O, Fonseca Leticia G, Carvalho Carlos A L B, Paiva Maria E C B, Antonini Francielle S, Nascimento Fabrício I M, Costa José V G, Alles Isabela, Aguilar-Nascimento José E, Pimenta Gunther P
Аннотация
BACKGROUND & AIMS: To evaluate the effects of abbreviated preoperative fasting using carbohydrate-containing beverages compared with traditional fasting or placebo in patients undergoing colorectal surgery, expanding upon prior meta-analyses with an updated and more comprehensive evidence base.
METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) comparing patients receiving preoperative carbohydrate-containing beverages with those undergoing conventional fasting or placebo. Main endpoints were plasma insulin and blood glucose levels at operating room admission and 24 h postoperatively. Secondary outcomes included length of hospital stay (LOS), time to first defecation, postoperative ileus, and patient-reported postoperative symptoms such as nausea, vomiting, anxiety, hunger, and thirst. Analyses were conducted in R software (v4.5.2) using a random-effects model, with calculation of mean difference (MD) and 95% confidence interval (CI). Certainty of evidence was assessed using the GRADE approach, and meta-regression was performed to evaluate the surgical approach as a potential moderator of outcomes.
RESULTS: Twenty trials including 1387 patients met the inclusion criteria; 49% received a preoperative oral carbohydrate-containing beverage. No significant differences were observed in plasma insulin levels at operating room admission (MD -0.19 μUI/mL; 95% CI -1.44 to 1.07; p = 0.59) or at 24 h postoperatively (MD -3.63 μUI/mL; 95% CI -10.49 to 3.23; p = 0.19). Blood glucose levels were also similar at operating room admission (MD 2.71 mg/dl; 95% CI -10.96 to 16.39; p = 0.61) and at 24 h postoperatively (MD -8.58 mg/dl; 95% CI -35.57 to 18.40; p = 0.41). LOS (MD -1.71 days; 95% CI -2.64 to -0.78; p = 0.0015) and time to first defecation (MD -0.95 days; 95% CI -1.72 to -0.19; p = 0.02) were reduced in the carbohydrate group.
CONCLUSION: Although preoperative CHO beverages did not significantly affect plasma insulin or blood glucose levels at operating room admission or 24 h postoperatively, they were associated with statistically significantly reduced LOS and earlier gastrointestinal recovery, confirmed to be independent of surgical approach by meta-regression, without increasing postoperative complications.
PROSPERO REGISTRATION NUMBER: CRD420261286419.
METHODS: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were systematically searched for randomized controlled trials (RCTs) comparing patients receiving preoperative carbohydrate-containing beverages with those undergoing conventional fasting or placebo. Main endpoints were plasma insulin and blood glucose levels at operating room admission and 24 h postoperatively. Secondary outcomes included length of hospital stay (LOS), time to first defecation, postoperative ileus, and patient-reported postoperative symptoms such as nausea, vomiting, anxiety, hunger, and thirst. Analyses were conducted in R software (v4.5.2) using a random-effects model, with calculation of mean difference (MD) and 95% confidence interval (CI). Certainty of evidence was assessed using the GRADE approach, and meta-regression was performed to evaluate the surgical approach as a potential moderator of outcomes.
RESULTS: Twenty trials including 1387 patients met the inclusion criteria; 49% received a preoperative oral carbohydrate-containing beverage. No significant differences were observed in plasma insulin levels at operating room admission (MD -0.19 μUI/mL; 95% CI -1.44 to 1.07; p = 0.59) or at 24 h postoperatively (MD -3.63 μUI/mL; 95% CI -10.49 to 3.23; p = 0.19). Blood glucose levels were also similar at operating room admission (MD 2.71 mg/dl; 95% CI -10.96 to 16.39; p = 0.61) and at 24 h postoperatively (MD -8.58 mg/dl; 95% CI -35.57 to 18.40; p = 0.41). LOS (MD -1.71 days; 95% CI -2.64 to -0.78; p = 0.0015) and time to first defecation (MD -0.95 days; 95% CI -1.72 to -0.19; p = 0.02) were reduced in the carbohydrate group.
CONCLUSION: Although preoperative CHO beverages did not significantly affect plasma insulin or blood glucose levels at operating room admission or 24 h postoperatively, they were associated with statistically significantly reduced LOS and earlier gastrointestinal recovery, confirmed to be independent of surgical approach by meta-regression, without increasing postoperative complications.
PROSPERO REGISTRATION NUMBER: CRD420261286419.