No Need To Fast Directly After Major Gynecologic Surgery

Armen Hareyan's picture
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Gynecologic Surgery

Having a bite to eat in the first 24 hours after major abdominal gynecologic surgery is safe - and could even help women recover faster, according to a new review of recent studies.

The finding breaks with a long tradition of withholding food and drink from patients until they show signs that their bowels have begun to work properly again after the disruptions of abdominal surgery.

In three studies of 413 women, however, an early return to food and drink after surgery did not lead to any of the feared complications such as vomiting, leakage in the abdominal cavity or wound rupture.

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The practice did slightly increase the chances of nausea, but it also shortened hospital days by an average of two days in one study, according to Dr. Kittipat Charoenkwan of Chiang Mai University, Thailand, and colleagues.

The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

In certain types of abdominal surgery, a quick return to oral feeding is the rule and not the exception, said Robert Sawyer, M.D., an associate professor of surgery at the University of Virginia. For instance, "there is a very strong trend to feed patients within 24 hours after laparoscopic procedures," he said.

Restoring oral feeding soon after surgery can have several benefits, Charoenkwan said. Good nutrition and normal bowel movement "contribute significantly to wound healing," he said. Fluids and food might also keep potentially harmful bacteria from taking over the gut and provoking serious infection.

Moreover, clinicians should not discount the psychological boost of a real meal, the Cochrane researchers say, although some women could be more distressed than others could by the increased nausea.

Physicians should decide whether to start early feeding on an individual basis, "essentially based on both a patient's condition and preference," Charoenkwan said.

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