BACKGROUND Postoperative ileus after colorectal surgery is a frequent problem that significantly prolongs hospital stay and increases perioperative costs. OBJECTIVE The aim was to evaluate the effect of standardized coffee intake on postoperative bowel movement after elective laparoscopic colorectal resection. DESIGN This is a prospective randomized controlled trial that was conducted between September 2014 and December 2016. SETTINGS This study was performed in a public cantonal hospital in Switzerland with accreditation for colon and rectum cancer surgery. PATIENTS Patients who underwent elective colorectal surgery were included. INTERVENTIONS Patients were randomly assigned either to the intervention group receiving coffee or the control group receiving tea. A total of 150 mL of the respective beverage was drunk 3 times per day every postoperative day until discharge. MAIN OUTCOME MEASURES The primary end point was time to first bowel movement. Secondary end points included the use of laxative, insertion of a nasogastric tube, length of hospital stay, and postoperative complications. RESULTS A total of 115 patients were randomly assigned: 56 were allocated to the coffee group and 59 to the tea group. After coffee intake, the first bowel movement occurred after a median of 65.2 hours versus 74.1 hours in the control group (intention-to-treat analysis; p = 0.008). The HR for earlier first bowel movement after coffee intake was 1.67 (p = 0.009). In the per-protocol analysis, hospital stay was shorter in the coffee group (6 d in the coffee group vs 7 d in the tea group; p = 0.043). LIMITATIONS The rate of protocol violation, mostly coffee consumption in the tea arm, was relatively high, even if patients were clearly instructed not to consume coffee if they were in the tea arm. CONCLUSIONS Coffee intake after elective laparoscopic colorectal resection leads to faster recovery of bowel function. Therefore, coffee intake represents a simple and effective strategy to prevent postoperative ileus. See Video Abstract at http://links.lww.com/DCR/A955.

Aim Laser haemorrhoidoplasty is associated with minimal postoperative pain and good symptom improvement in the short‐term. However, less is known about its long‐term efficacy. This study aims to determine the short‐ and long‐term outcomes of laser haemorrhoidoplasty. Method Between October 2010 and May 2012, 50 consecutive patients with grade II–III haemorrhoids were treated with laser haemorrhoidoplasty. Short‐term follow‐up was assessed on days 1, 30 and 60 and long‐term follow‐up was at 5 years (haemorrhoidal stage reduction, pain, patient satisfaction, symptom improvement, incapacity for work, continence, complications, recurrence). Results Short‐term follow‐up was achieved for all patients and long‐term follow‐up for 44/50 patients (88%). At short‐term follow‐up, haemorrhoidal stage reduction was documented in 49 (98%) patients. Complete or good symptom improvement was reported by 36/50 (72%) and 10/50 patients (20%) at 60 days. Postoperative complications occurred in 9/50 patients (18%) with three Clavien–Dindo grade IIIb complications (two fistulas, one incontinence), one grade IIIa (perianal thrombosis) and five grade I (one perianal thrombosis, two perianal eczema, one local bleeding, one anal fissure). Postoperative pain was low (visual analogue scale 0–1) at day 1 in 37/50 (74%), at day 30 in 47/50 (94%) and at day 60 in 50/50 patients (100%). After a mean follow‐up of 5.4 years (SD 5.4 months) the recurrence rate was 34% (15/44 patients) with a median time to recurrence of 21 months (range 0.2–6 years). Conclusion Although laser haemorrhoidoplasty achieves a high short‐term success rate with respect to stage reduction and symptom improvement, it is associated with a high rate of minor postoperative complications and long‐term recurrence. Therefore, laser haemorrhoidoplasty should be used with caution.