Abstracts
1999 Digestive Disease Week

# 2096 A PROSPECTIVE, RANDOMIZED TRIAL OF EARLY INITIATION AND HOSPITAL DISCHARGE ON A LIQUID DIET FOLLOWING ELECTIVE INTESTINAL SURGERY
Kevin E Behrns, Susan A Kircher, Michelle R Brownstein, Mark J Koruda, Univ of North Carolina, Chapel Hill, NC

Hospital discharge following elective intestinal surgery is often determined by patients' ability to tolerate solid food. Third-party payers seek hospital dismissal within days of operation, yet little data substantiates the safety of this practice. AIM: To determine if early initiation and discharge home on a clear liquid diet after intestinal surgery decrease length of stay (LOS) without increasing morbidity. METHODS: Forty-four patients undergoing intestinal surgery from 1995-1998 were randomized to receive either an oral clear liquid (CL; N=27) or a standard (SD; N=17) postoperative diet. The CL group received maximum of 30 ml/hr on postoperative day (POD) 2, unlimited CL on POD 3 and discharge on POD 4. The SD group received unlimited CL only after return of bowel function (passage flatus/stool) to ~750ml, were advanced to solid diet and discharged after tolerating 3 solid meals. All patients followed by phone contact, clinic visit and postoperative quality-of-life questionnaire. Primary endpoint was LOS, and secondary endpoint was hospital morbidity and readmission rate. Values are means + SEM. RESULTS: The 44 patients (22 men) aged 45+3 yrs underwent 26 large bowel, 16 small bowel and 2 combined small and large bowel operations. The LOS was 4.6+0.2 days in the CL group vs. 6.2 +1.1 days in SD group. Morbidity was 4% and 6% in CL and SD groups, respectively. Six patients were readmitted- 3/27 (11%) CL and 3/17 (18%) SD. One readmit in CL was due to dehydration. Hospital costs were +577 in CL and +508 in SD patients. Postoperative questionnaire showed similar GI and non-GI quality-of-life between groups. CONCLUSION: Hospital discharge on a clear liquid diet decreases LOS, and is safe in select patients undergoing elective intestinal surgery.

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