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Purpose of review Management of the postoperative response to surgical stress is an important issue in major surgery. Avoiding preoperative fasting using preoperative oral carbohydrates (POC) has been suggested as a measure to prevent and reduce the extent to which such derangements occur. This review summarizes the current evidence and rationale for this treatment. Recent findings A recent review from the Cochrane Collaboration reports enhanced gastrointestinal recovery and shorter hospitaldoi:10.1097/aco.0000000000000192 pmid:25827282 fatcat:jrs4qglzorbcnn72kjb6oxb33q