Early feeding compared with nasogastric decompression after major oncologic gynecologic surgery: a randomized study

Area of Science:

• Oncology
• Surgical Gastroenterology
• Gynecologic Oncology

Background:

• Postoperative ileus and delayed oral intake are common complications after major gynecologic surgery.
• Traditional management often involves nasogastric decompression and delayed feeding, potentially prolonging recovery.

Purpose of the Study:

• To assess the feasibility, safety, and tolerance of early oral feeding in patients undergoing surgery for gynecologic malignancies.
• To compare early feeding with traditional nasogastric decompression followed by feeding upon flatus passage.

Main Methods:

• Patients were randomized into two groups: early oral feeding (Arm A) or nasogastric decompression followed by feeding at the first passage of flatus (Arm B).
• Key outcomes included nausea, vomiting, time to flatus and stool passage, tolerance of a regular diet, postoperative stay duration, and complications.

Main Results:

• Early feeding significantly accelerated the resolution of postoperative ileus, return to a regular diet, and first stool passage (P < .01).
• Patients receiving early feeding experienced a shorter postoperative hospital stay (P < .05) with similar rates of nausea and vomiting compared to the control group.
• Nasogastric tubes caused significant discomfort (hindered deglutition, nasal soreness) in 88% of patients in Arm B; early feeding was feasible in 95% of patients.

Conclusions:

• Early oral feeding is a feasible and well-tolerated strategy for patients undergoing major surgery for gynecologic malignancies.
• This approach reduces postoperative discomfort and accelerates patient recovery, offering a superior alternative to traditional delayed feeding protocols.