[Evaluation of early oral feeding and traditional oral feeding in upper gastrointestinal surgeries]

Due to fears of postoperative complications following upper gastrointestinal surgeries [UGI], fasting before bowl function recovery is a traditional practice, but fasting following elective surgery is controversial. The aim of this study was to compare early oral feeding versus traditional oral feeding in patients who underwent UGI surgeries. Fifty two patients who underwent UGI anastomosis or surgery for various reasons were randomly divided into early oral feeding [EOF] group and traditional oral feeding [TOF] group. The nasogastric tube [NGT] removal time, tolerance of oral feeding, ileuses, nausea and vomiting, vital sign before and after surgery, postoperative stay, patients. satisfaction and complications were recorded. The mean time of NGT removal was 1.62 +/- 0.49 and 4.61 +/- 1.99 days in EOF group and TOF group respectively [p=0.0005]. The mean start time of oral feeding was 2.04 +/- 0.19 and 5.87 +/- 1.32 days in the EOF group and TOF group respectively [p=0.0005]. Tolerance of oral feeding was seen in 24 [92.3%] patients and 21 [91.3%] patients in the EOF and TOF groups respectively. Duration of hospital stay following surgery was 5.62 days in the EOF group and 8.04 days in the TOF group. 24[92.3%] out of 26 patients in the EOF group were satisfied with oral feeding that started in the second postoperative day. 13 patients [56.5%] complained of delay feeding in the TOF group. The results of the present study suggest that early oral feeding following upper gastrointestinal anastomosis or surgery is safe and can result in a shorter hospital stay and less cost

[Delay in diagnosis and treatment of gastric cancer from the begining of symptoms to surgery]

In developed countries diagnosis of gastric cancer is performed in early stages through screening and the 5 year survival rate has risen to 86%. Although the patients in developing countries have digestive symptoms for quite a while, they do not undergo early endoscopy. The patients refer to the physicians in developed stages. This research was conducted to determine the median time of delay from the beginning of symptoms to surgery. In this research 63 patients suffering from gastric cancer were investigated during 2004-2005. Research questionnaire was completed from patient's admission to endoscopy until surgery through interview with the patients. Mann- Whitney statistical test and SPSS software were used for data analysis. Out of 63 patients 48 [76.2%] were male and 43 [68.3%] rural esidents. The most common cancer area was cardia [31 patients] and the most common symptom was abdominal pain [28 patients]. The results showed of median total delay from the beginning of symptoms until surgery was 96 days, which the patient delays 8 days, from the first referring to endoscopy [General practitioner delay] 57 days, from endoscopy to pathology affirmation 12 days, and from pathology affirmation to surgery performance 7 days. Factors like place of residence, education, income and gender had no significant effect on the time of delay. Delay from referring to endoscopy performance and from performance of endoscopy to pathologic confirmation was higher than expected. Screening plan for timely referring of patients and performance of endoscopy seems essential. To reduce the time of delay cooperation of different units like medical education, hospital units, pathology and supply of necessary hospital equipment is highly recommended