Effects of coffee consumption on gut recovery after surgery of gynecological cancer patients: a randomized controlled trial

Abstract

BACKGROUND: Paralytic ileus that develops after elective surgery is a common and uncomfortable complication and is considered inevitable after an intraperitoneal operation. OBJECTIVE: The purpose of this study was to investigate whether coffee consumption accelerates the recovery of bowel function after complete staging surgery of gynecologic cancers. STUDY DESIGN: In this randomized controlled trial, 114 patients were allocated preoperatively to either postoperative coffee consumption with 3 times daily (n 58) or routine postoperative care without coffee consumption (n 56). Total abdominal hysterectomy and bilateral salpingooophorectomy with systematic pelvic and paraaortic lymphadenectomy were performed on all patients as part of complete staging surgery for endometrial, ovarian, cervical, or tubal cancer. The primary outcome measure was the time to the first passage of flatus after surgery. Secondary outcomes were the time to first defecation, time to first bowel movement, and time to tolerance of a solid diet. RESULTS: The mean time to flatus (30.2 +/- 8.0 vs 40.2 +/- 12.1 hours; P<.001), mean time to defecation (43.1 +/- 9.4 vs 58.5 +/- 17.0 hours; P<.001), and mean time to the ability to tolerate food (3.4 +/- 1.2 vs 4.7 +/- 1.6 days; P<.001) were reduced significantly in patients who consumed coffee compared with control subjects. Mild ileus symptoms were observed in 17 patients (30.4%) in the control group compared with 6 patients (10.3%) in the coffee group (P .01). Coffee consumption was well-tolerated and well-accepted by patients, and no intervention-related side-effects were observed. CONCLUSION: Coffee consumption after total abdominal hysterectomy and systematic paraaortic lymphadenectomy expedites the time to bowel motility and the ability to tolerate food. This simple, cheap, and welltolerated treatment should be added as an adjunct to the postoperative care of gynecologic oncology patients.