A Randomized Controlled Trial of Early Postoperative Feeding in Gynecologic Oncology Patients Undergoing Intra-abdominal Surgery

Pearl, Michael L.; Valea, Fidel A.; Fischer, Margaret; Mahler, Linda; Chalas, Eva

doi:10.1016/s0029-7844(98)00114-8

Cited by 74 publications

(26 citation statements)

References 13 publications

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“…In the USA, POI is estimated to cost between $5000 and $10 000 or a total of $1 billion per year due to discomfort, prolonged hospital stay and increased treatment costs . The incidence of POI after gynaecological surgery has a mean incidence of 10–15% (range of 5–25%) . The aetiology and pathogenesis of POI is multifactorial; therefore, a multimodal approach is required to counteract the morbidity of POI.…”

Section: Introductionmentioning

confidence: 99%

Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta‐analysis of randomised controlled trials

Craciunas

Sajid

Ahmed

2014

BJOG

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Background The incidence of postoperative ileus (POI) after gynaecological surgery is 10-15% Chewing gum following general surgery improves outcomes, including early flatus, early bowel sounds, and shortening of hospitalisation periods. There is currently no guideline that supports the use of chewing gum after caesarean sections.Objectives To systematically analyse the published randomised controlled trials regarding the effectiveness of chewing gum in preventing POI in women undergoing caesarean sections.Search strategy Systematic search of medical databases up to March 2013.Selection criteria Randomised controlled trials that reported the role of chewing gum in preventing POI in women undergoing caesarean sections.Data collection and analysis Two authors independently identified the relevant studies for inclusion, extracted outcome-related data, and analysed it systematically using REVMAN â . The combined outcome was expressed as an odds ratio and standardised mean difference.Main results Seven randomised controlled trials involving 1462 women (728 in the chewing gum group, 734 controls) were systematically analysed. There was significant heterogeneity (v 2 = 29.02, df = 7; P < 0.0001; I 2 = 76%) among the included trials. Among women undergoing caesarean sections, chewing gum reduced the risk of POI (odds ratio 0.36; 95% confidence interval 0.19-0.69; z = 3.08; P < 0.002) but did not affect duration of hospitalisation (P = 0.32).Conclusions Chewing gum for 30-60 minutes at least three times a day appears to be effective in reducing the incidence and consequences of POI following caesarean sections.

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Section: Introductionmentioning

confidence: 99%

Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta‐analysis of randomised controlled trials

Craciunas

Sajid

Ahmed

2014

BJOG

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“…When postoperative ileus develops, it is usually transient and clinically not significant. Therefore, feeding within 24 hours after laparotomy is tolerated, and the feed is absorbed 4-5. …”

Section: Introductionmentioning

confidence: 99%

A randomized controlled trial evaluating early versus traditional oral feeding after colorectal surgery

Dağ

Çolak

Türkmenoğlu

et al. 2011

Clinics

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OBJECTIVE:This prospective randomized clinical study was conducted to evaluate the safety and tolerability of early oral feeding after colorectal operations.METHODS:A total of 199 patients underwent colorectal surgery and were randomly assigned to early feeding (n = 99) or a regular diet (n = 100). Patients' characteristics, diagnoses, surgical procedures, comorbidity, bowel movements, defecation, nasogastric tube reinsertion, time of tolerance of solid diet, complications, and length of hospitalization were assessed.RESULTS:The two groups were similar in terms of gender, age, diagnosis, surgical procedures, and comorbidity. In the early feeding group, 85.9% of patients tolerated the early feeding schedule. Bowel movements (1.7±0.89 vs. 3.27±1.3), defecation (3.4±0.77 vs. 4.38±1.18) and time of tolerance of solid diet (2.48±0.85 vs. 4.77±1.81) were significantly earlier in the early feeding group. There was no change between the groups in terms of nasogastric tube reinsertion, overall complication or anastomotic leakage. Hospitalization (5.55±2.35 vs. 9.0±6.5) was shorter in the early feeding group.CONCLUSIONS:The present study indicated that early oral feeding after elective colorectal surgery was not only well tolerated by patients but also affected the postoperative outcomes positively. Early postoperative feeding is safe and leads to the early recovery of gastrointestinal functions.

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“…The randomized clinical trials of early enteral feeding in POI have showed the controversial results 17 . Some studies showed that early feeding reduced the duration of POI, 23–25 while others failed to show any differences 26–29 . Our current study demonstrated that feeding stimulated gastric motility in the group of manipulation although its motility was impaired before the feeding.…”

Section: Discussionmentioning

confidence: 42%

Impaired gastric motor activity after abdominal surgery in rats

Fukuda

Tsuchida

Koda

et al. 2004

Neurogastroenterology Motil

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Postoperative ileus (POI) is a transient bowel dysmotility that occurs following abdominal surgery. Several mechanisms have been proposed such as neural reflex and inflammatory changes. We focused on gastric motility after abdominal surgery in rats. To investigate the time course of gastric motility after surgery, gastric motility was continuously recorded before, during and after surgery. After laparotomy, terminal ileum was manipulated for 10 min. Gastric motility was recorded by a strain gauge transducer implanted on the serosal surface of the stomach. To investigate whether peripheral sympathetic nerve is involved in the pathogenesis of POI, effects of guanethidine and celiac ganglionectomy were tested on the postoperative gastric motility. Although isoflurane anaesthesia reduced the gastric motility to 40%, the motility recovered immediately when isoflurane was withdrawn. Intestinal manipulation reduced the postoperative gastric motility for 3-24 h after surgery, compared with preoperative levels. Guanethidine administration and celiac ganglionectomy restored the impaired gastric motility. Feeding increased the gastric motility in each group. It is suggested that the pathogenesis of postoperative gastric ileus induced by intestinal manipulation involves viscero-sympathetic pathways. Intestinal manipulation causes impaired gastric motility via inhibitory sympathetic efferent pathway. Feeding may improve the postoperative gastric motility.

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A Randomized Controlled Trial of Early Postoperative Feeding in Gynecologic Oncology Patients Undergoing Intra-abdominal Surgery

Abstract: Early postoperative feeding in gynecologic oncology patients undergoing intra-abdominal surgery is safe and well tolerated.

Cited by 74 publications

References 13 publications

Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta‐analysis of randomised controlled trials

Chewing gum in preventing postoperative ileus in women undergoing caesarean section: a systematic review and meta‐analysis of randomised controlled trials

A randomized controlled trial evaluating early versus traditional oral feeding after colorectal surgery

Impaired gastric motor activity after abdominal surgery in rats

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