Randomized Controlled Trial
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2025; 17(8): 108669
Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.108669
Effects of early diet resumption on the incidence of complications following polypectomy: A randomized controlled trial
Hui-Hui Yan, Zhu-Yun Ding, Lei-Lei Wang, Dan-Dan Zhong, Xi-Feng Jin, Xiao-Chen Liu, Jian-Ting Cai, Xin-Liang Lu
Hui-Hui Yan, Dan-Dan Zhong, Xi-Feng Jin, Xiao-Chen Liu, Jian-Ting Cai, Xin-Liang Lu, Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Zhu-Yun Ding, Department of Gastroenterology, Tiantai County People's Hospital, Taizhou 317200, Zhejiang Province, China
Lei-Lei Wang, Department of Clinical Nutrition, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Co-first authors: Hui-Hui Yan and Zhu-Yun Ding.
Co-corresponding authors: Jian-Ting Cai and Xin-Liang Lu.
Author contributions: Yan HH and Ding ZY analyzed the data, designed the figures, and wrote the draft as the co-first authors of the paper; Yan HH, Ding ZY, Zhong DD, Jin XF and Liu XC collected the data; Yan HH, Zhong DD, Cai JT, and Lu XL provided the cases; Wang LL, Cai JT, and Lu XL helped to revise the manuscript; Cai JT and Lu XL designed the study and provide the support as the co-corresponding authors; all authors had access to the study data and reviewed and approved the final manuscript.
Supported by National Natural Science Foundation of China, No. 82073160.
Institutional review board statement: The study was reviewed and approved by the the Institutional Review Board of The Second Affiliated Hospital of Zhejiang University School of Medicine.
Clinical trial registration statement: This study is registered at ClinicalTrials.gov. The registration identification number is NCT05466903.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The datasets generated and analyzed during the current study are not publicly available because individual privacy could be compromised. However, they are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Liang Lu, MD, PhD, Chief Doctor, Department of Gastroenterology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Shangcheng District, Hangzhou 310009, Zhejiang Province, China. lux@zju.edu.cn
Received: April 29, 2025
Revised: May 31, 2025
Accepted: June 30, 2025
Published online: August 27, 2025
Processing time: 118 Days and 23.8 Hours
Abstract
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.

Keywords: Colorectal polyps; Polypectomy; Early diet resumption; Post-polypectomy complications; Randomized controlled trial

Core Tip: This randomized controlled trial included 1502 patients with colorectal polyps under 3 cm at the Second Affiliated Hospital of Zhejiang University School of Medicine. The participants were randomly assigned to an experimental group and a control group. The experimental and control groups resumed oral intake at 2 hours and 6 hours post-polypectomy, respectively. Throughout the 14-day follow-up, the post-polypectomy complications of the two groups were evaluated. The results revealed that early diet resumption does not increase the risk of post-polypectomy complications; conversely, a lower incidence of hypoglycemia and a shorter length of stay were found post-polypectomy.