A Randomized Controlled Trial of a Regular Diet as the First Meal in Gynecologic Oncology Patients Undergoing Intraabdominal Surgery

Pearl, Michael L.; Frandina, Martina; Mahler, Linda; Valea, Fidel A.; DiSilvestro, Paul; Chalas, Eva

doi:10.1097/00006250-200208000-00005

Cited by 15 publications

(22 citation statements)

References 16 publications

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“…Rationale: There is no physiologic basis for the argument that patients should be advanced to clear liquids first following surgery prior to ingesting a solid meal. While clear liquids may be swallowed more easily and, if isotonic, may leave the stomach more rapidly, they are more readily aspirated 439 . In an early RCT of 241 patients who had undergone an abdominal operation, there were no significant differences in dietary intolerance between those receiving a clear‐liquid diet (n = 135) or a regular diet (n = 106) 440 .…”

Section: O Postoperative Major Surgery (Sicu Admission Expected)mentioning

confidence: 99%

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

McClave

Taylor

Martindale

et al. 2016

J Parenter Enteral Nutr

2,560

1,248

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Section: O Postoperative Major Surgery (Sicu Admission Expected)mentioning

confidence: 99%

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

McClave

Taylor

Martindale

et al. 2016

J Parenter Enteral Nutr

2,560

1,248

View full text Add to dashboard Cite

“…The CLD is an inadequate source of all nutrients in all age groups. At least 2 RCTs have demonstrated the safe and efficacious elimination of the CLD and early advancement directly to a regular diet following abdominal and gynecologic surgery 56 , 57 . Statistically significant increases in nausea and vomiting have been demonstrated, but these have not been associated with deleterious effects.…”

Section: The Postoperative Periodmentioning

confidence: 99%

An Evidence‐Based Approach to Perioperative Nutrition Support in the Elective Surgery Patient

Miller

Wischmeyer

Taylor

et al. 2013

J Parenter Enteral Nutr

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In surgical practice, great attention is given to the perioperative management of the elective surgical patient with regard to surgical planning, stratification of cardiopulmonary risk, and postoperative assessment for complication. However, growing evidence supports the beneficial role for implementation of a consistent and literature-based approach to perioperative nutrition therapy. Determining nutrition risk should be a routine component of the preoperative evaluation. As with the above issues, this concept begins with the clinician's first visit with the patient as risk is assessed and the severity of the surgical insult considered. If the patient is an appropriate candidate for benefit from preoperative support, a plan for initiation and reassessment should be implemented. Once appropriate nutrition end points have been achieved, special consideration should be given to beneficial practices the immediate day preceding surgery that may better prepare the patient for the intervention from a metabolic standpoint. In the operating room, consideration should be given to the potential placement of enteral access during the index operation as well as judicious and targeted intraoperative resuscitation. Immediately following the intervention, adequate resuscitation and glycemic control are key concepts, as is an evidence-based approach to the early advancement of an enteral/oral diet in the postoperative patient. Through the implementation of perioperative nutrition therapy plans in the elective surgery setting, outcomes can be improved.

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“…17,20,21 Details of the early feeding intervention varied substantially between studies. Regular diet on day 1 was investigated by 3 RCTs 16,17,19 and compared with nil by mouth until presence of bowel sounds or flatus in 2 trials, 16,17 and clear fluids on day 1 followed by diet as tolerated in 1 trial. 19 Early feeding was associated with significantly faster recovery of bowel function with shorter times to flatus and to tolerance of regular diet.…”

Section: Characteristics Of Studies Includedmentioning

confidence: 99%

“…Regular diet on day 1 was investigated by 3 RCTs 16,17,19 and compared with nil by mouth until presence of bowel sounds or flatus in 2 trials, 16,17 and clear fluids on day 1 followed by diet as tolerated in 1 trial. 19 Early feeding was associated with significantly faster recovery of bowel function with shorter times to flatus and to tolerance of regular diet. Significantly shorter length of stay in hospital was reported in 4 trials, with average differences ranging from 0.2 to 1.7 days.…”

Section: Characteristics Of Studies Includedmentioning

confidence: 99%

Enhanced Recovery After Surgery for Advanced Ovarian Cancer: A Systematic Review of Interventions Trialed

Lindemann

Kok

Stockler

et al. 2017

Int J Gynecol Cancer

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Few studies have specifically studied ERAS interventions in ovarian cancer. All studies on protocols including multiple interventions were susceptible to bias. Early feeding is the intervention that is best supported by randomized trials. Application of evidence for ERAS derived from nonovarian cancer is challenged by the differences not only in the scope of surgery but also in ovarian cancer patients' comorbidities. Postoperative morbidity is particularly high in these patients because of their poor nutritional status, perioperative fluids shifts, and long operating times. These patients may also show excessive response to surgical stress. Innovative, randomized trials are needed to reliably determine the feasibility, safety, and effectiveness of specific ERAS interventions in ovarian cancer.

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A Randomized Controlled Trial of a Regular Diet as the First Meal in Gynecologic Oncology Patients Undergoing Intraabdominal Surgery

Cited by 15 publications

References 16 publications

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient

An Evidence‐Based Approach to Perioperative Nutrition Support in the Elective Surgery Patient

Enhanced Recovery After Surgery for Advanced Ovarian Cancer: A Systematic Review of Interventions Trialed

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