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Meta-Analysis
. 2024 Jun;76(3):769-782.
doi: 10.1007/s13304-024-01847-x. Epub 2024 May 3.

Caffeine intake enhances bowel recovery after colorectal surgery: a meta-analysis of randomized and non-randomized studies

Affiliations
Meta-Analysis

Caffeine intake enhances bowel recovery after colorectal surgery: a meta-analysis of randomized and non-randomized studies

Sascha Vaghiri et al. Updates Surg. 2024 Jun.

Abstract

Postoperative ileus (POI) after colorectal surgery is a major problem that affects both patient recovery and hospital costs highlighting the importance of preventive strategies. Therefore, we aimed to perform a systematic analysis of the effects of postoperative caffeine consumption on bowel recovery and surgical morbidity after colorectal surgery. A comprehensive literature search was conducted through September 2023 for randomized and non-randomized trials comparing the effect of caffeinated versus non-caffeinated drinks on POI by evaluating bowel movement resumption, time to first flatus and solid food intake, and length of hospital stay (LOS). Secondary outcome analysis included postoperative morbidity in both groups. After data extraction and inclusion in a meta-analysis, odds ratios (ORs) for dichotomous variables and standardized mean differences (SMDs) for continuous outcomes with 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed in cases of substantial heterogeneity. Six randomized and two non-randomized trials with a total of 610 patients were included in the meta-analysis. Caffeine intake significantly reduced time to first bowel movement [SMD -0.39, (95% CI -0.66 to -0.12), p = 0.005] and time to first solid food intake [SMD -0.41, (95% CI -0.79 to -0.04), p = 0.03] in elective laparoscopic colorectal surgery, while time to first flatus, LOS, and the secondary outcomes did not differ significantly. Postoperative caffeine consumption may be a reasonable strategy to prevent POI after elective colorectal surgery. However, larger randomized controlled trials (RCTs) with homogeneous study protocols, especially regarding the dosage form of caffeine and coffee, are needed.

Keywords: Caffeine intake; Coffee intake; Colorectal surgery; Postoperative complications; Postoperative ileus.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA diagram of study identification and selection for review analysis
Fig. 2
Fig. 2
Risk of bias summary according to a RoB 2 b ROBINS-I
Fig. 3
Fig. 3
a Forest plot of significant primary outcomes (caffeinated drink versus control): time to first bowel movement. b Forest plot of significant primary outcomes (subgroup caffeinated coffee versus decaffeinated coffee): time to first bowel movement. c Forest plot of significant primary outcomes (caffeinated drink versus control): time to first solid diet intake. d Forest plot of significant primary outcomes (caffeinated drink versus control): length of hospital stay
Fig. 3
Fig. 3
a Forest plot of significant primary outcomes (caffeinated drink versus control): time to first bowel movement. b Forest plot of significant primary outcomes (subgroup caffeinated coffee versus decaffeinated coffee): time to first bowel movement. c Forest plot of significant primary outcomes (caffeinated drink versus control): time to first solid diet intake. d Forest plot of significant primary outcomes (caffeinated drink versus control): length of hospital stay

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