{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T00:20:13Z","timestamp":1780100413034,"version":"3.54.0"},"reference-count":38,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>International guidelines regarding the resumption of postoperative intake of liquids are limited. Surgical patients are subjected to unnecessarily prolonged fasting times after surgery, which can lead to increased postoperative complications. Research has shown that a shorter fasting duration can enhance recovery, improve rehabilitation, and reduce the psychological stress associated with major surgeries in these patients. Given these potential benefits, we performed this meta\u2010analysis that aims to explore how the duration of postoperative liquid fasting affects the length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We systematically searched the literature for papers published in English between 1 January 2010 and 6 January 2023. Meta\u2010analyses were performed using R (version 4.0.2). When means and standard deviations were lacking, these were derived from medians and interquartile ranges if available. For the length of hospital stay (a continuous variable), the standardised mean difference (SMD) and 95% confidence intervals were calculated to summarise the data. We used a random\u2010effects model when high heterogeneity was observed (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009&gt;\u200950%). To account for potential causes of heterogeneity, we performed subgroup analyses according to the type of papers (dividing papers into randomised controlled trials and observational studies; and papers with or without mean derivation from medians). Risk of publication bias was checked by drawing funnel plots.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of nine studies were included. The definition of \u2018early feeding\u2019 varied according to the type of procedures included across studies. Shorter postoperative fasting with earlier postoperative intake of liquids was associated with a decrease in the length of hospital stay with a mean difference of 0.9\u2009day (\n                      <jats:italic>p\u2009&lt;<\/jats:italic>\n                      \u20090.05). Results remained similar after sensitivity analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Shorter postoperative fasting with earlier postoperative intake of liquids is associated with a decreased length of hospital stay. Future research is needed to explore the relation between postoperative fasting times and length of hospital stay according to the types of surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Editorial Comment<\/jats:title>\n                    <jats:p>This systematic review confirms that successful early postoperative intake of liquids is associated with post\u2010operative benefit defined as shorter hospital stay. This was shown in the selected non\u2010interventional studies as well as the trial results, where all the individual study findings for the chosen outcome were in the same direction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aas.70180","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:59:31Z","timestamp":1770339571000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Impact of Early Postoperative Oral Intake on the Length of Hospital Stay: A Meta\u2010Analysis"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7863-2038","authenticated-orcid":false,"given":"Anne Marie","family":"Camilleri Podesta","sequence":"first","affiliation":[{"name":"Department of Anaesthesia Intensive Care and Pain Medicine, Mater Dei Hospital  Msida Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1852-9917","authenticated-orcid":false,"given":"Marie Adrienne","family":"Zerafa Simler","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Intensive Care and Pain Medicine, Mater Dei Hospital  Msida Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Nagrebetsky","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6759-3929","authenticated-orcid":false,"given":"Ib","family":"Jammer","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Intensive Care Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta Dias","family":"Vaz","sequence":"additional","affiliation":[{"name":"Unidade Local de Sa\u00fade de Gaia e Espinho  V. 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Gaia Portugal"},{"name":"MEDCIDS, Faculty of Medicine, University of Porto  Porto Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"R\u00fcggeberg","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Pain Therapy Helios Klinikum Emil von Behring  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2377-3327","authenticated-orcid":false,"given":"Ehrenfried","family":"Schindler","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care Medicine University Hospital Bonn  Bonn Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Hammer","sequence":"additional","affiliation":[{"name":"Medical Library, University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Bilotta","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care Policlinico Umberto I Hospital, La Sapienza University of Rome  Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7189-8984","authenticated-orcid":false,"given":"Jamie","family":"Elmawieh","sequence":"additional","affiliation":[{"name":"D\u00e9partement d'Anesth\u00e9sie, Chirurgie et Interventionnel Gustave Roussy  Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e3283495ba1"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2006.02.001"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2020.09.002"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2022.12.017"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7316.773"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10120-013-0275-5"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-021-02186-6"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-013-3336-2"},{"issue":"4","key":"e_1_2_11_10_1","first-page":"607","article-title":"Early Enteral Nutrition After Total Gastrectomy for Gastric Cancer","volume":"23","author":"Chen W.","year":"2014","journal-title":"Asia Pacific Journal of Clinical Nutrition"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-6533-1"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2020.105094"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3343\/alm.2021.41.2.139"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1108\/JHOM-10-2017-0275"},{"key":"e_1_2_11_15_1","first-page":"1","article-title":"Prolonged Length of Stay as a Contributor to Burnout, Interprofessional Conflict and System Fatigue: A Qualitative Study of Inpatient Team Perspectives","volume":"26","author":"Gao L.","year":"2022","journal-title":"Hospital Topics"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.5195\/jmla.2018.345"},{"key":"e_1_2_11_18_1","unstructured":"National Institute for Health and Care Excellence (NICE) \u201cPerioperative Care in Adults \u201d2020 https:\/\/www.nice.org.uk\/guidance\/ng180\/resources\/perioperative\u2010care\u2010in\u2010adults\u2010pdf\u201066142014963397."},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000001599"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_2_11_21_1","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2018"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/09622802231172043"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000323"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcma.2015.07.004"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.04.036"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/1751-2980.12501"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm.2020.04.13"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.12.026"},{"issue":"5","key":"e_1_2_11_29_1","first-page":"806","article-title":"Early Postoperative Oral Feeding Impacts Positively in Patients Undergoing Colonic Resection: Results of a Pilot Study","volume":"25","author":"Consoli M. 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