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Effect of Coffee on the Length of Postoperative Ileus After Elective Laparoscopic Left-Sided Colectomy: A Randomized, Prospective Single-Center Study

Dulskas, Audrius1; Klimovskij, Michail1; Vitkauskiene, Marija1; Samalavicius, Narimantas E. M.D., PhD1,2

doi: 10.1097/DCR.0000000000000449
Original Contributions: Colorectal Disease

BACKGROUND: Postoperative ileus is common problem after colorectal surgery. A positive effect of coffee to bowel movement has been described. It is still unclear whether coffee decreases the risk of postoperative ileus.

OBJECTIVE: The purpose of this study was to determine whether consuming a 100-mL cup of coffee is effective in preventing or reducing postoperative ileus.

DESIGN: This was a prospective, single-center, randomized controlled study.

SETTINGS: The study was conducted at a university teaching hospital.

PATIENTS: All of the patients who were scheduled for elective laparoscopic left-sided colectomy at our hospital after the detection of malignant disease in a preoperative biopsy between January 2013 and December 2014 entered the study. The patients were assigned randomly before surgery to receive coffee with caffeine (first group), coffee without caffeine (second group), or water (third group) after the procedure (100 mL 3 times daily).

MAIN OUTCOME MEASURES: The primary end point was time to first bowel movement; secondary end points were time to first flatus and time to tolerance of solid food.

RESULTS: A total of 105 patients were randomly assigned, 35 to each group. Fifteen patients were excluded. Patient demographic characteristics were similar in the groups. The time until the first bowel movement (measured in days) was significantly (p < 0.05) shorter in the decaffeinated coffee group (3.00 ± 1.50) versus the coffee with caffeine (3.75 ± 1.53) and water groups (4.14 ± 1.14). The time until tolerance of solid food was significantly shorter in decaffeinated group versus coffee with caffeine and water groups (1.85 versus 2.60 and 2.80; p < 0.05). Time until the first flatus (1.47 versus 1.57 and 1.77 for decaffeinated coffee versus coffee with caffeine and water; p > 0.05) did not show statistical significance. Postoperative hospital stay was similar in all 3 of the groups.

LIMITATIONS: This is a single-center study with a relatively small sample size.

CONCLUSIONS: Coffee consumption after colectomy was safe and in the decaffeinated group associated with a reduced time to first bowel action. Caffeine is not a main ingredient affecting the length of postoperative ileus.

1 Centre of Oncosurgery, National Cancer Institute, Vilnius, Lithuania

2 Centre of Oncosurgery, National Cancer Institute, Clinic of Internal, Family Medicine, and Oncology, Faculty of Medicine, Vilnius, Lithuania

Financial Disclosure: None reported.

Correspondence: Audrius Dulskas, Centre of Oncosurgery, National Cancer Institute, 1 Santariskiu St, Vilnius LT 08406, Lithuania. E-mail: audrius.dulskas@gmail.com

© 2015 The American Society of Colon and Rectal Surgeons