咖啡摄入是否能减少腹腔镜择期结直肠手术后的术后肠梗阻？一项前瞻性、随机对照研究：咖啡研究。

Does Coffee Intake Reduce Postoperative Ileus After Laparoscopic Elective Colorectal Surgery? A Prospective, Randomized Controlled Study: The Coffee Study.

机构信息

Department for General, Visceral and Vascular Surgery, Kantonsspital Baden, Baden, Switzerland.

Department of Surgery and Transplantation, University Hospital Zurich, Zurich, Switzerland.

出版信息

Dis Colon Rectum. 2019 Aug;62(8):997-1004. doi: 10.1097/DCR.0000000000001405.

DOI:10.1097/DCR.0000000000001405

PMID:30998528

Abstract

BACKGROUND

Postoperative ileus after colorectal surgery is a frequent problem that significantly prolongs hospital stay and increases perioperative costs.

OBJECTIVE

The aim was to evaluate the effect of standardized coffee intake on postoperative bowel movement after elective laparoscopic colorectal resection.

DESIGN

This is a prospective randomized controlled trial that was conducted between September 2014 and December 2016.

SETTINGS

This study was performed in a public cantonal hospital in Switzerland with accreditation for colon and rectum cancer surgery.

PATIENTS

Patients who underwent elective colorectal surgery were included.

INTERVENTIONS

Patients were randomly assigned either to the intervention group receiving coffee or the control group receiving tea. A total of 150 mL of the respective beverage was drunk 3 times per day every postoperative day until discharge.

MAIN OUTCOME MEASURES

The primary end point was time to first bowel movement. Secondary end points included the use of laxative, insertion of a nasogastric tube, length of hospital stay, and postoperative complications.

RESULTS

A total of 115 patients were randomly assigned: 56 were allocated to the coffee group and 59 to the tea group. After coffee intake, the first bowel movement occurred after a median of 65.2 hours versus 74.1 hours in the control group (intention-to-treat analysis; p = 0.008). The HR for earlier first bowel movement after coffee intake was 1.67 (p = 0.009). In the per-protocol analysis, hospital stay was shorter in the coffee group (6 d in the coffee group vs 7 d in the tea group; p = 0.043).

LIMITATIONS

The rate of protocol violation, mostly coffee consumption in the tea arm, was relatively high, even if patients were clearly instructed not to consume coffee if they were in the tea arm.

CONCLUSIONS

Coffee intake after elective laparoscopic colorectal resection leads to faster recovery of bowel function. Therefore, coffee intake represents a simple and effective strategy to prevent postoperative ileus. See Video Abstract at http://links.lww.com/DCR/A955.

TRIAL REGISTRATION

clinicaltrials.gov identifier: NCT02469441.

摘要

背景

结直肠手术后的术后肠梗阻是一个常见问题，它显著延长了住院时间并增加了围手术期的成本。

目的

评估标准化咖啡摄入对择期腹腔镜结直肠切除术后肠道蠕动的影响。

设计

这是一项于 2014 年 9 月至 2016 年 12 月进行的前瞻性随机对照试验。

地点

这项研究在瑞士一家具有结肠和直肠癌症手术认证的公立州立医院进行。

患者

纳入接受择期结直肠手术的患者。

干预措施

患者被随机分配到干预组（接受咖啡）或对照组（接受茶）。术后每天饮用 3 次，每次 150 毫升各自的饮料，直至出院。

主要观察终点

主要终点是首次排便时间。次要终点包括泻药使用、鼻胃管插入、住院时间和术后并发症。

结果

共有 115 名患者被随机分配：56 名分配到咖啡组，59 名分配到茶组。饮用咖啡后，中位数首次排便时间为 65.2 小时，而对照组为 74.1 小时（意向治疗分析；p = 0.008）。咖啡摄入后早期首次排便的 HR 为 1.67（p = 0.009）。在方案符合分析中，咖啡组的住院时间更短（咖啡组 6 天，茶组 7 天；p = 0.043）。