A randomized placebo controlled trial of preoperative carbohydrate drinks and early postoperative nutritional supplement drinks in colorectal surgery

Colorectal Dis. 2013 Jun;15(6):737-45. doi: 10.1111/codi.12130.


Aim: There is evidence that preoperative carbohydrate drinks and postoperative nutritional supplements improve the outcome of colorectal surgery. There is little information on their individual contribution.

Method: A prospective four-arm double-blind controlled trial was carried out in which patients were randomized to carbohydrate or placebo drinks preoperatively and a polymeric supplement or placebo drink postoperatively. The primary outcome was insulin resistance (using the short insulin tolerance test and HOMA-IR). Secondary outcomes included handgrip strength, pulmonary function, intestinal permeability and postoperative complications.

Results: A total of 120 patients were randomized to four demographically well matched groups. Patients who received preoperative and postoperative supplements had better glucose homeostasis (P = 0.004), peak expiratory flow rate (P = 0.035), handgrip strength (P = 0.002) and less insulin resistance (P = 0.001) compared with those who only received placebo drinks.

Conclusion: Oral nutritional supplements given preoperatively and postoperatively improve postoperative handgrip strength, pulmonary function and insulin resistance. A weaker effect was seen in patients who received supplements either preoperatively or postoperatively. Oral nutritional supplements should be given both preoperatively and postoperatively.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged
  • Aged, 80 and over
  • Beverages*
  • Blood Glucose
  • Colectomy / methods*
  • Colorectal Neoplasms / surgery*
  • Dietary Carbohydrates / therapeutic use*
  • Dietary Supplements*
  • Double-Blind Method
  • Female
  • Hand Strength
  • Humans
  • Insulin / blood
  • Insulin Resistance*
  • Intestine, Small / physiopathology
  • Male
  • Middle Aged
  • Perioperative Care / methods*
  • Permeability
  • Postoperative Care / methods
  • Postoperative Complications / prevention & control*
  • Preoperative Care / methods
  • Respiratory Function Tests
  • Treatment Outcome


  • Blood Glucose
  • Dietary Carbohydrates
  • Insulin