Brief Reports
Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2005; 11(18): 2802-2805
Published online May 14, 2005. doi: 10.3748/wjg.v11.i18.2802
Effect of water-soluble contrast in colorectal surgery: A prospective randomized trial
Jia-Hui Chen, Chung-Bao Hsieh, Pei-Chieh Chao, Hsiao-Dung Liu, Chung-Jueng Chen, Yao-Chi Liu, Jyh-Cherng Yu
Jia-Hui Chen, Chung-Bao Hsieh, Hsiao-Dung Liu, Chung-Jueng Chen, Yao-Chi Liu, Jyh-Cherng Yu, Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, China
Pei-Chieh Chao, Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, China
Jia-Hui Chen, Department of Surgery, Hualien Armed Forces General Hospital, Hualien, Taiwan, China
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Jyh-Cherng Yu, Division of General Surgery, Tri-Service General Hospital, 325, Sec. 2, Chen-Kung Road, Neihu 114, Taipei, Taiwan, China. albert0920@yahoo.com.tw
Telephone: +886-2-8792-7191 Fax: +886-2-8792-7372
Received: November 2, 2004
Revised: November 3, 2004
Accepted: December 20, 2004
Published online: May 14, 2005
Abstract

AIM: Postoperative gastrointestinal-tract motility is normally delayed. Early feeding after colorectal surgery has been reported recently, but late feeding is common. Gastrografin not only enhances bowel peristalsis, but also decreases bowel-wall edema. Whether contrast medium allows early oral feeding and reduces the duration of hospitalization requires clarification.

METHODS: Fifty patients underwent elective colorectal surgery in a regional medical center. Patients were prosp-ectively randomized into a Gastrografin group or control group (n = 25 each). Patients in the Gastrografin group began their feeding schedule with 100 mL of 5% dextrose water with 100 mL of Gastrografin on postoperative d 3 and were advanced to a full liquid diet when the contrast reached the colon in 4 h. Patients in the control group began their feeding schedule with 200 mL of 5% dextrose water on postoperative d 3 and were advanced to a full liquid diet after the passage of flatus and stool. Nasogastric tubes were inserted for persistent postoperative vomiting. Fullness, nausea, vomiting, complications, time of anesthesia, time of operation, time of mobilization, time of oral feeding, and duration of hospital stay were recorded and analyzed with Student’s t-test.

RESULTS: In the Gastrografin group, one patient had aspiration pneumonia and one patient had anastomotic leakage resulting in sepsis and eventual death. This mortality was excluded from the subsequent statistical analysis. In the control group, two patients had wound infections. There was no significant difference between the two groups at the time of anesthesia, time of operation, or time of mobilization. There were significant differences between the two groups in the time of oral feeding (3.3±0.3 d in the Gastrografin group vs 4.8±0.4 d in the control group; P = odds ratio--, 95%CI [-0.5 to +0.7 d]) and in the length of hospital stay (7.6±1.1 d in the Gastrografin group vs 10.2±1.3 d in the control group; P = odds ratio--, 95% CI [-1.2 to +1.4 d]).

CONCLUSION: Gastrografin not only allowed early oral feeding but also reduced the duration of hospitalization after elective colorectal surgery.

Keywords: Colorectal surgery; Contrast; Gastrografin