Prescribed Postoperative Fasting Versus Traditional Postoperative Fasting and their Impact on Postoperative Complications and Length of Hospital Stays in Gastrointestinal Surgery Patients

Abstract

Aim: This structured literature review aims to critically evaluate extant evidence to compare prescribed postoperative fasting versus traditional postoperative fasting and their impact on complications and length of hospital stays. Background: The gastrointestinal (GI) tract (GIT) is vast and complex, starting from the oral cavity and terminating in the anal canal, and containing various accessory organs (Ogobuiro et al., 2013). There can be structural and functional disorders that affect the GI tract often necessitating surgery. GI surgeries are common and increasingly being performed and therefore require effective postoperative care strategies that hep to enhance recovery, reduces the risk of complications, and reduce the length of postoperative hospitalization. Postoperative fasting has been a means of achieving these goals, however, the length of such fasting has been called into question by current evidence. Therefore, this review is aimed at comparing the current prescribed postoperative fasting time as encouraged in international guidelines versus traditional fasting time as practiced in some places and their impact on complications and length of hospital stays. Methods: Four empirical studies were retrieved through systematic search of electronic databases and their findings extracted and synthesized. Only peer-reviewed, randomized controlled trial (RCT) studies published in the English language between 2014 and 2024 and compared prescribed fasting versus traditional fasting and their impact on postoperative complications and length of hospital stays are included in this review. Results: A combined total of 249 participants was recorded across the four included primary studies. Clinical outcomes were better in the prescribed fasting group. Abdominal distention (14.8% – 30% vs 16.7% – 45%); vomiting (7.4% – 50% vs 16% – 65%); aspiration pneumonia (0 – 2.5% vs 0 – 10%); nausea (20% vs 26.7%); Passage of flatus (2.57 hours – 3 days vs 3.06 hours – 4 days). Postoperative length of hospital stays was shorter in the prescribed fasting group (4 – 6 days vs 6.1 – 9 days). Conclusion: Findings suggest that prescribed fasting is associated with lower incidence of postoperative complications and shortens postoperative hospitalization.