Posted by Article on 6/7/2002, 12:00 pm

MedscapeWire Earlier Feeding After Gyn Surgery Shortens Hospital Stay Laurie Barclay, MD June 4, 2002 — Women should be fed the first day after major abdominal surgery rather than waiting for bowel function to return as has been standard practice, according to the results of a randomized, prospective trial reported in the May issue of the American Journal of Obstetrics and Gynecology. "Early postoperative dietary advancement after major abdominal gynecologic surgery results in a decreased length of hospital stay and appears to be safe, with no increased adverse effects," write Helen L. Steed and colleagues from the University of Alberta in Edmonton, Canada. In this prospective, randomized trial, gynecologic oncology and urogynecology patients who underwent major abdominal gynecologic surgery were assigned to one of two groups. The traditional feeding group consisted of 49 patients who received nothing by mouth until documentation of bowel function, followed by slow advancement to solid diet. The early feeding group was made up of 47 patients who began clear fluids on the first postoperative day. Once they tolerated 500 mL of clear fluid, they received a regular diet. The median length of hospital stay was six days for the traditional feeding group and four days for the early feeding group (P = .0001). The incidence of emesis, ileus, and other postoperative complications was similar in the two groups. Benefits of early postoperative feeding may include improved nutritional status promoting wound strength and healing, regeneration of mucosal villi decreasing the risk of sepsis, and improved sense of well-being. "This approach of early feeding may prove to be useful as medical care costs continue to increase," the authors write. Am J Obstet Gynecol. 2002;186:861-865 Reviewed by Gary D. Vogin, MD -------------------------------------------------------------------------------- Laurie Barclay, is a staff writer with WebMD.