Comparison of early and on-demand maternal feeding after Caesarean delivery: a prospective randomised trial

INTRODUCTION@#This study aimed to compare early and on-demand maternal feeding after Caesarean delivery in terms of gastrointestinal complaints and patient satisfaction.@*METHODS@#A total of 262 women with uncomplicated singleton term pregnancies who underwent a Caesarean section under regional anaesthesia were randomised to a soft food diet served at Postoperative Hour 2 (early feeding group) or eating whenever they wanted to upon return to the ward (on-demand group). Patient satisfaction scores at the time of discharge and gastrointestinal complaints were compared.@*RESULTS@#The fed-early group comprised 133 (50.8%) women and the on-demand group comprised 129 (49.2%) women. Major characteristics and surgical procedures were comparable between the two groups. No significant between-group differences in demographic criteria or surgical procedures were evident (p > 0.05). The mean time to the first feeding was 120.00 ± 00.00 minutes for the early feeding group as compared to 236.59 ± 107.74 minutes for the on-demand feeding group (p = 0.001). Satisfaction levels did not differ significantly between the two groups (p = 0.366). Duration to first breastfeeding, analgesia on the ward, passage of flatus, defecation, mobilisation and urination after catheter removal did not differ significantly between the two groups (p > 0.05).@*CONCLUSION@#Early initiation of solid food in low-risk women after Caesarean delivery under regional anaesthesia was associated with high satisfaction and did not increase gastrointestinal complaints. We suggest having flexibility in terms of postoperative feeding time. This may shorten hospitalisation time and reduce hospitalisation costs.

Early port-site metastasis during neoadjuvant chemotherapy in advanced stage ovarian cancer: report of two cases / 부인종양

Port-site metastases in gynecological malignancies subsequent to laparoscopy have been reported with an incidence of 1.1-16%. These metastases tend to be disappearing after primary debulking surgery and subsequent primary chemotherapy. Local resection, chemotherapy and/or radiotherapy have been defined in the management of these metastases with enhanced clinical success. However, in extremely rare cases these metastases were also defined very early during neoadjuvant chemotherapy. Herein, we present two ovarian cancer cases which are clinically diagnosed with port site metastasis during neoadjuvant chemotherapy following diagnostic laparoscopy. Although neoadjuvant chemotherapy is sometimes needed in cases of fully advanced ovarian cancers, port-site metastasis may be encountered during neoadjuvant chemotherapy. The possible poor prognosis of these patients, especially those who have ascites, should make us careful in performing diagnostic laparoscopy with preventive measures for port-site metastasis and to start the chemotherapy immediately.