Residents' Papers:GynecologyA randomized controlled trial of early versus “traditional” postoperative oral intake after major abdominal gynecologic surgery☆
Section snippets
Material and methods
After obtaining ethics committee approval and patient consent, 107 patients in gynecologic oncology and urogynecology at the Royal Alexandra Hospital Site in Edmonton, Alberta, Canada, were prospectively randomized with a computer-generated random number list. Patients were identified in the preadmission clinic from October 2000 through June 2001 and were randomized by the clinic nurses according to the computer assignment.
Exclusion criteria included pregnancy, postoperative intensive care unit
Results
There were 107 patients enrolled in this trial, and complete data were available for 96 patients. Seven women were excluded because of intraoperative injury of the gastrointestinal tract, and 4 patients were excluded because of self-withdrawal. There were no significant demographic differences between groups (Table I), and the types of surgical procedures performed were similar between the 2 groups (Table I).
Table II summarizes the intraoperative data collected.The operating time, type of
Comment
The results of this study strongly suggest that early postoperative dietary advancement after major abdominal gynecologic surgery results in a decreased LOHS. The results do not support the tradition of withholding oral intake after surgery because of the concern of postoperative ileus.1, 2, 3, 4, 5
Research in the area of gastrointestinal physiology and motility indicate that postoperative early feeding may be tolerated. The stomach and pancreas secrete 1 to 2 liters of fluid per day, which is
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Cited by (65)
Enhanced recovery programs in gastrointestinal surgery: Actions to promote optimal perioperative nutritional and metabolic care
2020, Clinical NutritionCitation Excerpt :Anyhow, patient and hospital personnel should be educated on this component of ERAS programs because mobilization may facilitate tolerance with early food intake and functional recovery in general. There is robust evidence to conclude that allowing food without delay (at will) is safe and effective, and that withholding of oral intake (nil-by-mouth) for the first postoperative days is unnecessary in most types of major abdominal operations including surgeries necessitating proximal bowel anastomosis [137–143]. However, during the first postoperative days, it may be difficult to achieve the full energy and protein requirements exclusively with natural foods.
Early enteral feeding after pediatric abdominal surgery: A systematic review of the literature
2020, Journal of Pediatric SurgeryNutrition interventions in patients with gynecological cancers requiring surgery
2017, Gynecologic OncologyCitation Excerpt :The combination of reduced nutrition intake, reduced nutritional absorption, and increased metabolic demand can result in a negative nutritional balance and a diminishing nutritional status [5,28–30]. In advanced stages of gynecological cancer, complex surgical procedures are often required to achieve optimal cytoreduction, most frequently hysterectomy with or without bowel resections [18,20,23,24]. These procedures can result in additional strain and elevated production of pro-inflammatory cytokines, further contributing to proteolysis and subsequent loss of lean tissue.
Hysterectomy for benign disease: Clinical practice guidelines from the French College of Obstetrics and Gynecology
2016, European Journal of Obstetrics and Gynecology and Reproductive Biology
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Reprint requests: Helen Steed, MD, Department of Obstetrics and Gynecology, CSC – 201, Royal Alexandra Hospital Site, 10240 Kingsway Ave, Edmonton, AB, Canada T5H 3V9. E-mail: [email protected]