The study, published in Nutrients, is said to be the first to look at the effect of preoperative whey protein-infused carbohydrate drink and postoperative early oral feeding in affecting Enhanced Recovery after Surgery (ERAS) of cancer patients.
A total of 118 patients suffering from gynaecologic cancers were recruited from the National Cancer Institute at Putrajaya, Malaysia.
Sixty-two were placed in the intervention group, where they drank a beverage consisting of carbohydrates and whey protein on the 6th and 3rd hour before the operation.
After the operation, they were allowed to consume a specially formulated drink consisting of carbohydrates and whey protein. When they can tolerate at least 500ml of this particular drink and other clear fluid, they were allowed to eat a solid diet.
Another 56 patients in the control group had to undergo fasting at least 12 hours before the operation and were allowed to drink clear fluid once there were bowel sounds. Once they were able to tolerate the clear fluid diet, they then proceeded to a nourishing fluid, soft diet then a regular solid diet.
Results showed that there were no serious side effects (such as vomiting or nausea) identified with drinking the whey protein three hours before operation.
In terms of hospital stay, the intervention group had a shorter postoperative hospital stay at 78.13 ± 33.05 hours as compared to the control group (99.49 ± 22.54 hours).
They also had a lower rate of hospital re-admission (6%), which was 10% lower than the control group. Common reasons for re-admission include infection and wound debridement.
In addition, the intervention group’s digestive system resumed to normal more quickly than the control group.
They were able to tolerate a solid diet post-operation in a shorter time (22.05 ± 11.70 hours) than the control group (52.90 ± 16.43 hours).
Also, their bowel function returned back to normal quick than the control group at 28.32 ± 19.06 hours and 53.10 ± 17.29 hours respectively.
The intervention group also fared better in terms of preserved muscle mass and handgrip strength.
For instance, their preserved muscle mass was 0.4 ± 1.7kg, more than that of the control group at -0.7 ± 2.6kg.
Citing previous research, the researchers said that the approach used in the intervention group was useful as it led to earlier food toleration and accelerates intestinal function recovery.
“The findings of this study showed that the multimodal ERAS approach with preoperative whey protein-infused carbohydrate loading and postoperative early oral feeding resulted in positive postoperative outcomes, less nutritional depletion, greater muscle mass conservation and strength, and concealed inflammatory response,” the researchers concluded.
For future study, they recommended a long-term study one month and three months after the operation to observe the nutrition and functional status of the patients.
Preoperative Whey Protein-Infused Carbohydrate Loading and Postoperative Early Oral Feeding among Surgical Gynecologic Cancer Patients: An Open-Labelled Randomized Controlled Trial
Authors: Chiou Yi Ho, et al