Document Detail


Reduction of postoperative complication rate with the use of early oral feeding in gynecologic oncologic patients undergoing a major surgery: a randomized controlled trial.
MedLine Citation:
PMID:  19760046     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A randomized controlled trial was performed to assess the outcome of early oral postoperative feeding (EOF) compared with traditional oral feeding (TOF) in gynecologic oncology patients undergoing a complex laparotomy, including upper abdominal surgery. METHODS: Patients aged 18-75 years, undergoing an elective laparotomy and with a preoperative suspicion of gynecologic malignancy, were eligible. Exclusion criteria included infectious conditions, intestinal obstruction, severe malnutrition, American Society of Anesthesiologists score C4, intestinal resection, and postoperative stay in the intensive care unit lasting 24 h. Patients allocated to EOF received liquid diet in the first postoperative day and then regular diet. Patients received traditional feeding scheme until resolution of postoperative ileus to start liquid diet. The primary end-point of the trial was length of hospital stay. RESULTS: Between January 1, 2007, and November 17, 2007, a total of 143 patients were randomized to receive either EOF or TOF. Hospital stay for patients who received EOF (n=71) was 4.7 vs. 5.8 days for the TOF group (n=72) (P=0.006). The mean level of postoperative satisfaction was significantly higher in the EOF group (82.8 vs. 71.7 mm, P B 0.001). Patients who received the TOF scheme had significantly higher overall postoperative complications (39 vs. 17% in EOF group, P=0.003) and infective complications (14% in TOF group vs. 3% in EOF group, P=0.017). Variables such as nausea and vomiting, analgesic and antiemetic requirement as well as level of pain and quality of life were not different between groups. CONCLUSIONS: On the basis of these findings, the policy of EOF should be used after a complex gynecologic oncologic laparotomy.
Authors:
Lucas Minig; Roberto Biffi; Vanna Zanagnolo; Anna Attanasio; Carmen Beltrami; Luca Bocciolone; Edoardo Botteri; Nicoletta Colombo; Simona Iodice; Fabio Landoni; Michele Peiretti; Giovanni Roviglione; Angelo Maggioni
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Annals of surgical oncology     Volume:  16     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-27     Completed Date:  2010-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3101-10     Citation Subset:  IM    
Affiliation:
Gynecology Department, European Institute of Oncology, Milan, Italy. lucasminig@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Eating
Female
Follow-Up Studies
Genital Neoplasms, Female / pathology,  surgery*
Humans
Laparotomy*
Length of Stay
Middle Aged
Neoplasm Staging
Pain, Postoperative
Postoperative Complications*
Prognosis
Quality of Life
Survival Rate
Time Factors
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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