Randomization to nutritional intervention at home did not improve postoperative function, fatigue or well-being.

BACKGROUND: Postoperative fatigue and deterioration in functional capacity have been correlated to postoperative weight loss. This suggested that nutritional support to enhance the regain of weight might improve upon the convalescence. METHODS: Patients were allocated randomly at discharge to standard management or to dietary advice and protein-rich supplements for 4 months. The convalescence of 32 patients admitted electively for colorectal surgery and of 21 operated on for acute obstruction or severe peritonitis was studied. RESULTS: The intervention substantially increased protein intake, gain in body-weight and lean body mass, especially in the legs as shown by dual-energy X-ray absorptiometry. Changes in work capacity, hand grip and pinching strength, fatigue and quality of life were similar in patients in control and intervention groups and had returned to preoperative values 1-2 months after operation, although fatigue was increased at 2-3 months. CONCLUSIONS: This study did not support the hypothesis that changes in weight were important for the changes in function and fatigue in patients with small to moderate weight loss.