Early versus delayed (traditional) oral fluids and food for reducing complications after major abdominal gynaecologic surgery

Early feeding after major abdominal gynaecologic surgery appears to be safe without increased gastrointestinal or other postoperative complications.

A Cochrane review included 5 studies with a total of 631 women. Rates of developing postoperative ileus were comparable between study groups (RR 0.47, 95% CI 0.17 to 1.29, P = 0.14, 3 RCTs, n = 279, I² = 0%, moderate-quality evidence). Early commencement of oral fluids and food was not associated with increased nausea or vomiting (RR 1.03, 95% CI 0.64 to 1.67; 4 RCTs, N = 484, I² = 73%, moderate-quality evidence). Early feeding was associated with shorter time to the presence of bowel sound (MD -0.32 days, 95% CI -0.61 to -0.03, P = 0.03, 2 RCTs, n = 338, I² = 52%, moderate-quality evidence) and faster onset of flatus(MD -0.21 days, 95% CI -0.40 to -0.01, P = 0.04, 3 RCTs, n = 444, I² = 23%, moderate-quality evidence), shorter time to first solid diet (MD -1.47 days, 95% CI -2.26 to -0.68; 2 RCTs, n = 301, I² = 92%, moderate-quality evidence), and a shorter hospital stay (MD -0.92 days, 95% CI -1.53 to -0.31; 4 RCTs, n = 484, I² = 68%, moderate-quality evidence). Infectious complications were less common in the early feeding group (RR 0.20, 95% CI 0.05 to 0.73; 2 RCTs, n = 183, I² = 0%, high-quality evidence).

Comment: The quality of evidence is downgrade by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (limited study size for each comparison).

Ədəbiyyat

1. Charoenkwan K, Matovinovic E. Early versus delayed oral fluids and food for reducing complications after major abdominal gynaecologic surgery. Cochrane Database Syst Rev 2014;(12):CD004508.