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Table 1 Characteristics of included studies

From: Early oral protein-containing diets following elective lower gastrointestinal tract surgery in adults: a meta-analysis of randomized clinical trials

Study Patient population Protocol for early nutrition intervention Control
Beier-Holgersen and Boesby, 1996 60 patients with gastrointestinal disease undergoing abdominal surgery (87% underwent colorectal surgery). Start within 4 h of surgery (POD 0): 60 mls of protein drink (Nutricia Nutridrink, Orange) every h, for total of 600 ml. POD 1: 1000 ml of protein drink; POD 2: 1400 ml protein drink; POD 3 and 4: 1800 ml protein drink. Placebo (water with orange flavor) following same protocol as early protein drink group.
Carr et al., 1996 28 patients undergoing intestinal resection distal to the ligament of Treitz. Start within 2 to 3 h of surgery (POD 0): 25 ml/h EN (Fresubin, Fresenius) via N-J tube. Rate increased by 25 ml every 4 h until target of 35 ml/kg/day achieved. NPO until passage of flatus.
Lau et al., 2014 111 elective colorectal surgery patients. Start POD 1: Solid diet that left minimal residue in the lower intestinal tract after digestion and absorption. Start POD 1: Clear liquids, specifically omitting all solids (ex., milk, and fruit juice with pulp). POD 2: Advanced to solid diet.
Minig et al., 2009 51 gynecologic oncology patients. (Over 70% also had rectosigmoid resection in addition to hysterectomy.) Start POD 0: Clear fluids and other liquids (tea, apple juice, etc.). If fluids tolerated, progress to regular diet by end of POD 1. NPO until resolution of ileus.
Mulrooney et al., 2005 73 patients undergoing colonic resection Start within 24 h of surgery: 25 ml/h EN (Nutrison Standard, Nutricia) via N-J tube; POD 2: 50 ml/h EN; POD 3: 75 ml/h: POD 4: EN increased to calculated nutritional targets. NPO until passage of flatus.
Ortiz et al., 1996 190 patients undergoing elective colon and rectal surgery. Early removal of NG tube with clear liquids on POD 0 followed by regular diet on POD 1. NPO until resolution of ileus.
Shen 2013 82 patients with colorectal cancer undergoing surgery. Start POD 1: 200 mls 0.9% Saline and 200 ml EN; POD 2: 500 to 1000 ml EN; POD 3: 1500 to 2000 ml of EN; POD 4: 2000 ml EN continued until POD 7. Start standard PN POD 2: standard PN continued until POD 7.
Stewart et al., 1998 88 patients undergoing elective colorectal resection with anastomosis, without stoma formation. Start within 4 h of surgery (POD 0): free fluids; POD 1: Solid diet. NPO until passage of flatus or bowel movement.
  1. POD: postoperative day; EN enteral nutrition solution containing protein; NPO nil per os; PN parenteral nutrition solution containing glucose, amino acids, and protein; N-J naso-jejunal tube