[A comparison of safety and efficacy of early and delayed oral feeding after abdominal hysterectomy]

ABSTRACT

Postoperatively, early enteral feeding has been associated with I-educed protein-store depletion, improved wound healing, and a positive psychological impact, resulting in faster recovery. Thus, early oral feeding after abdominal surgery has been the goal of surgeons for several decades. To evaluate the safety and efficacy of early oral feeding as compared with those placed on a delayed feeding schedule in patients undergoing abdominal hysterectomy. This was a prospective randomized study of 80 women who were undergoing abdominal hysterectomy. They were enrolled in a randomized controlled trial and compared with delayed postoperative oral feeding. Women were divided in two groups. Patients in the early feeding group received oral diet within 6-8 hours of surgery, but those in the control group were given nothing by mouth for 18- 24 hours. They were given clear liquids, and were advanced to solid food on the second or third postoperative day. We reviewed the gastrointestinal outcomes and hospital stays eighty women were studied, with assigned 40 versus 40 to each group. Two groups were similar in age, disease and surgical length. In early-fed patients nausea was more developed [43% versus] 22.4%. p=0.006]. [Despite this, vomiting, abdominal distention, length of post-operative ileus, need of nasogastric tube use was comparable in both groups. Time to development of bowel sound] [1.7 +/- 1.1 days vs 2.2 +/- 1.1 days, p=0.007], time to initiation of solid diet] [1.8 +/- 1.2 days vs. 2.9 +/- 1.4 days, p<0.0001] and hospital stay] [2.3 +/- 1 days vs. 3.9 +/- 1.3 days, p<0.003] were significantly sooner in the early feeding group. Early postoperative feeding in abdominal hysterectomy seems to be safe, well tolerated, and may lead to earlier hospital discharge