The efficacy of preoperative low-residue diet on postoperative ileus following cesarean section

Objective To evaluate the efficacy of preoperative low-residue diet on postoperative ileus in women undergoing elective cesarean section (CS). Methods This is a surgeon-blind, randomized controlled trial enrolling pregnant women at >= 39 weeks of gestation undergoing elective CS. Patients were preoperatively randomized to receive either low-residue diet (arm A) or free diet (arm B) starting from three days before surgery. The primary outcome was the postoperative ileus. The secondary outcomes were the postoperative pain (assessed through VAS scale), the quality of the surgical field (scored using a 5-point scale, from poor to excellent), postoperative complications, and the length of hospital stay. Perioperative data were collected and compared between groups. Results A total of 166 patients were enrolled and randomized in arm A (n = 83) and arm B (n = 83). Postoperative ileus over 24 h was significantly shorter in arm A, compared to arm B (19.3% vs 36.2%). The surgical evaluation of small intestine was scored >= 3 in 96.4% of arm A patients versus 80.7% in arm B, while evaluation of large intestine, respectively, in 97.7% and 81.9%. Postoperative pain after 12 h from CS was significantly lower in arm A (VAS, 3.4 +/- 1.7) compared to arm B (VAS, 4.1 +/- 1.8). There were no significant differences as regards postoperative pain at 24 and 48 h, nausea/vomit, surgical complications, and hospital stay. Conclusions Implementation of a preoperative low-residue diet for women scheduled for elective CS would reduce postoperative ileus and pain. Further large-scale studies are required before translating these research findings into routine obstetrical practice.

Automated summary

This study evaluated the efficacy of preoperative low-residue diet in reducing postoperative ileus and pain in women undergoing elective cesarean section. It suggests that implementing a low-residue diet before surgery can be beneficial for obstetrical practices. However, further large-scale studies are needed before these research findings can be translated into routine clinical practice.