Basic nutritional investigationShrinking preoperative fast time with maltodextrin and protein hydrolysate in gastrointestinal resections due to cancer

ObjectiveProlonged preoperative fasting increases postoperative hospital length of stay and current evidence recommends patients drink a carbohydrate-based liquid drink 2 h before surgery. The aim of this study was to investigate whether the addition of hydrolyzed protein to a carbohydrate-based drink would reduce both the inflammatory response and hospital length of stay.MethodsWe evaluated 22 patients of both sexes, undergoing gastrointestinal resection due to cancer. Patients were randomized into two groups: control group (n = 12; 6-8 h fast) and the intervention group (n = 10; fasted to solids for 6 h; and given a beverage containing 11% pea protein hydrolysate and 89% carbohydrates (79% maltodextrin and 21% sucrose), 400 mL the night before and 200 mL 3 h before surgery. Blood samples were collected the morning before surgery and on postoperative day 2.ResultsOverall mortality was 4.5% (one case, control group). The duration of postoperative hospital stay was twofold longer in the control group (P = 0.04). A significant increase of serum C-reactive protein/albumin ratio was observed in controls compared with the intervention group (P = 0.04).ConclusionThe abbreviation of preoperative fasting time to 3 h using a solution containing carbohydrates and hydrolyzed pea proteins reduces the acute-phase inflammatory response and decreases the postoperative length of stay in patients undergoing major surgery for a malignancy.