The efficacy of preoperative low-residue diet on postoperative ileus following cesarean section

Figures & data

Figure 1. CONSORT flow diagram.

Table 1. List of allowed and not allowed foods.

Foods	Allowed	Not allowed
Flour	White bread, crackers	Whole wheat bread, pasta, rice, cornflakes, foods containing bran or corn, oat flour, whole grain cereals.
Desserts	Ice pops, white yogurt	Chocolate, dried fruit, seeds, coconut, fruit yogurt, popcorn.
Fruits	Cooked or puréed fruit (apples and pears) and ripe bananas	Uncooked fruit, berries, dried fruits, seeds, nuts
Vegetables and legumes	Boiled potatoes and carrots	All other vegetables, both cooked and raw, legumes such as broccoli, cabbages, cauliflower, spinach, peas, lettuce, tomatoes and any other vegetables with seeds, beans, chickpeas, etc.
Meat	Chicken and turkey meat, fish, eggs	Red meal, salami and sausages
Broth	Vegetable broth	Puréed vegetable soups, creams, and soups.
Drinks	Tea, chamomile, herbal tea, skimmed milk, all decaffeinated drinks, fruit juices without pulp	Espresso, cappuccino, whole or partially skimmed milk, fruit juice with pulp and all alcoholic beverages.

Table 2. Preoperative low-residue diet (starting three days before CS).

Natural oligomineral water; toasted bread.
BREAKFAST	• Lemon juice (4 ml) ○ Rusks (30 g, 124 kcal) ○ Tea (1.5 g)
LUNCH	FIRST DISHES (max 1): Rice (80 g, 285 kcal) with oil (13 ml, 119 kcal) Pasta (80 g, 287 kcal) with oil (13 ml, 119 kcal) Liquid semolina in filtered vegetable broth (80 g, 280 kcal) SECOND DISHES (max 1): Fillets of plaice (200 g, 182 kcal) Slice of chicken breast (200 g, 220 kcal) Slice of turkey breast (200 g, 238 kcal) White cattle meatballs (100 g, 231 kcal) Pork chop (150 g, 270 kcal) Grilled slices of beef (150 g, 216 kcal) Steamed hamburger (110 g, 199 kcal) Cod fillet dressed with olive oil (200 g, 166 kcal) Homogenized meat (200 g, 168 kcal) CONTOURS (max 1): Carrots (150 g, 41 kcal) dressed with olive oil (10 g, 119 kcal) Potatoes (80 g, 83 kcal) dressed with olive oil (13 ml, 119 kcal) Courgettis (150 g, 55 kcal) dressed with olive oil (13 ml, 119 kcal) FRUIT (max 1): Banana (89 kcal) Fruit mousse (100 g, 60 kcal) Fruit juice without sugar (200 ml, 100 kcal)
DINNER	FIRST DISHES (max 1): Rice (80 g, 285 kcal) with oil (13 ml, 119 kcal) Pasta (80 g, 287 kcal) with oil (13 ml, 119 kcal) Liquid semolina in filtered vegetable broth (80 g, 280 kcal) SECOND DISHES (max 1): Slice of chicken breast (200 g, 220 kcal) Slice of turkey breast (200 g, 238 kcal) Platessa fillet (200 g, 118 kcal) with oil (13 ml, 119 kcal) Raw ham (100 g, 238 kcal) White cattle meatballs (100 g, 231 kcal) Slice of grilled cattle (200 g, 220 kcal) Homogenized meat (200 g, 168 kcal) Parmesan cheese (50 g, 196 kcal) CONTOURS (max 1): Carrots (150 g, 41 kcal) dressed with olive oil (10 g, 119 kcal) Potatoes (80 g, 83 kcal) dressed with olive oil (13 ml, 119 kcal) Courgettis (150 g, 55 kcal) dressed with olive oil (13 ml, 119 kcal) FRUIT (max 1): Banana (89 kcal) Fruit mousse (100 g, 60 kcal) Fruit juice without sugar (200 ml, 100 kcal)

Table 3. Clinical characteristics of OB group patients.

Variable	Low-residue diet (n = 83)	Free diet (n = 83)
Age (years)^a	34.37 ± 6.17	34.42 ± 7.51
Weight (kg)^a	73.69 ± 11.75	72.9 ± 11.8
Height (cm)^a	163.20 ± 6.04	164.46 ± 6.38
BMI (kg/m^2)^a	27.81 ± 4.38	27.06 ± 4.44
Indications for CS
Previous CS	43 (51.8%)	47 (56.6%)
Maternal indications	21 (25.3%)	18 (21.7%)
Maternal request	12 (14.5%)	13 (15.7%)
Fetal indications	9 (10.8%)	6 (7.2%)
Malpresentation	2 (2.4%)	3 (3.6%)
Comorbidities	33 (39.8%)	30 (36.14%)

^aData are expressed as mean ± standard deviation (SD).

BMI: body mass index; CS: cesarean section; NS: not significant; SD: standard deviation.

Table 4. Intraoperative variables, complications, and quality of the surgical field.

Variable	Low-residue diet (n = 83)	Free diet (n = 83)	p Value
Hemoglobin (g/dL)^a
Preoperative	11.7 ± 1.4	12.9 ± 1.1	NS
Postoperative	10.8 ± 1.2	12.8 ± 1.5	NS
Operation duration (minutes)^a	58.8 ± 23.8	62.7 ± 30.5	NS
Intraoperative complications	2 (2.4%)	3 (3.6%)	NS
Quality of the surgical field Small intestine
Score <3	4 (4.8%)	16 (19.3%)	<.001
Score ≥3	80 (96.4%)	67 (80.7%)
Large intestine
Score <3	3 (3.6%)	15 (18.1%)	<.001
Score ≥3	81 (97.6%)	68 (81.9%)

^aData are expressed as mean ± standard deviation (SD).

NS: not significant; SD: standard deviation.

Table 5. Postoperative variables and complications.

Variable	Low-residue diet (n = 83)	Free diet (n = 83)	p Value
Postoperative complications
Anemia	4 (4.8%)	6 (7.22%)	NS
Fever/Infection	3 (3.6%)	3 (3.6%)	NS
TEV	0	1 (1.2%)	NS
Postoperative ileus (hours)			.02
Within 24 h	67 (80.7%)	53 (63.85%)
Over 24 h	17 (20.5%)	30 (36.14%)
VAS at 12 h^a	3.35 ± 1.74	4.06 ± 1.81	.01
VAS at 24 h^a	3.96 ± 1.72	4.34 ± 1.83	NS
VAS at 48 h^a	3.84 ± 1.66	4.02 ± 1.90	NS
Nausea at 24 h	80 (96.4%)	82 (98.8%)	NS
0–2	4 (4.8%)	1 (1.2%)
3–5
Vomit at 24 h	83 (100%)	82 (98.8%)	NS
0–2	0	1 (1.2%)
3–5
Days of hospital stay^a	3 ± 1	3 ± 1	NS
Analgesic request	63 (75.9%)	70 (84.3%)	NS

^aData are expressed as mean ± standard deviation (SD).

NS: not significant; SD: standard deviation; VTE: venous thromboembolism; VAS: visual analog scale.