Effects of early diet resumption on the incidence of complications following polypectomy: A randomized controlled trial

BACKGROUND Patients with early oral intake after intestinal surgery achieve better nutritional status and fewer postoperative complications. However, no guidelines or expert consensus have established the optimal timing for diet resumption following colorectal polypectomy. AIM To determine the timing, feasibility, and clinical benefits of early diet resumption following colorectal polypectomy. METHODS In the Second Affiliated Hospital of Zhejiang University School of Medicine, a total of 1502 patients with polyps under 3 cm were recruited and randomly assigned to an experimental group (n = 751) and a control group (n = 751). Following polypectomy, the experimental group consumed rice soup at 2 hours, while the control group received rice soup at 6 hours. The study focused on delayed post-polypectomy bleeding (DPPB), with secondary evaluation of post-polypectomy perforation, hypoglycemia, fever, and length of stay (LOS). RESULTS The comparison between the two groups revealed no significant differences in DPPB rates (4.7% vs 5.5%, P = 0.480) and major bleeding rates (1.5% vs 2.1%, P = 0.332). Both groups displayed median bleeding times of 2 days. No notable differences in perforation (0.0% vs 0.3%, P = 0.479) and fever rates (2.1% vs 2.9%, P = 0.324) were observed between the two groups. However, the experimental group showed significantly lower incidence of hypoglycemia (0.4% vs 1.5%, P < 0.05) and shorter LOS [1 (1, 2) day vs 2 (1, 2) days, P < 0.001] following polypectomy. Subgroup analyses further confirmed that early diet resumption had no adverse effects on patients, irrespective of polyp count, size, pathology, or polypectomy modalities. CONCLUSION Early diet resumption following colorectal polypectomy for polyps not exceeding 3 cm is advisable as it does not significantly increase the risk of complications.