A RANDOMIZED CONTROLLED TRIAL OF EARLY POSTOPERATIVE FEEDING IN GYNECOLOGIC ONCOLOGY PATIENTS UNDERGOING INTRAABDOMINAL SURGERY

Objective: To evaluate the safety and efficacy of early oral feeding a fter intra-abdominal surgery in gynecologic oncology patients. Methods : During a 1-year period, 200 gynecologic oncology patients undergoing intra-abdominal surgery were enrolled in a randomized controlled tria l of early compared with traditional oral postoperative feeding. Patie nts allocated to early postoperative oral feeding began a clear liquid diet on the first postoperative day and then advanced to a regular di et as tolerated. Patients allocated to traditional postoperative oral feeding received nothing by mouth until return of bowel function (defi ned as the passage of flatus in the absence of vomiting or abdominal d istention), then began a clear liquid diet, and advanced to a regular diet as tolerated. Results: Age, case distribution, surgery length, bl ood loss, and first passage of flatus were similar in the early and tr aditional feeding groups. Significantly more patients in the early gro up developed nausea. Despite this, the incidence of vomiting, abdomina l distention, incidence and duration of nasogastric tube use, and perc entage of patients who tolerated clear liquid and regular diets on the first attempt were comparable in both groups. Time to development of bowel sounds, time to initiation of clear Liquid and regular diets, an d hospital stay were significantly longer in the traditional group. Ma jor complications (eg, pneumonia, atelectasis, and wound complications ) and febrile morbidity occurred equally in both groups. There were no known anastamotic complications or aspirations in either group. Posto perative changes in hematologic indices and electrolytes were comparab le in both groups. Conclusion: Early postoperative feeding in gynecolo gic oncology patients undergoing intra-abdominal surgery is safe and w ell tolerated. (C) 1998 by The American College of Obstetricians and G ynecologists.