scholarly journals Early oral feeding is safe and useful after rectosigmoid resection with anastomosis during cytoreductive surgery for primary ovarian cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kazuyoshi Kato ◽  
Kohei Omatsu ◽  
Sanshiro Okamoto ◽  
Maki Matoda ◽  
Hidetaka Nomura ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Cytoreductive Surgery ◽  
Group Versus ◽  
Postoperative Hospital Stay ◽  
Oral Feeding ◽  
Early Oral Feeding ◽  
Rectosigmoid Resection ◽  
Primary Ovarian Cancer

Abstract Background The aim of this study was to investigate the safety and clinical usefulness of early oral feeding (EOF) after rectosigmoid resection with anastomosis for the treatment of primary ovarian cancer. Methods We performed a retrospective review of all consecutive patients who had undergone rectosigmoid resection with anastomosis for primary ovarian, tubal, or peritoneal cancer between April 2012 and March 2019 in a single institution. Patient-related, disease-related, and surgery-related data including the incidence of anastomotic leakage and postoperative hospital stay were collected. EOF was introduced as a postoperative oral feeding protocol in September 2016. Before the introduction of EOF, conventional oral feeding (COF) had been used. Results Two hundred and one patients who underwent rectosigmoid resection with anastomosis, comprised of 95 patients in the COF group and 106 patients in the EOF group, were included in this study. The median number of postoperative days until the start of diet intake was 5 (range 2–8) in the COF group and 2 (range 2–8) in the EOF group (P < 0.001). Postoperative morbidity was equivalent between the groups. The incidence of anastomotic leakage was similar (1%) in both groups. The median length of the postoperative hospital stay was reduced by 6 days for the EOF group: 17 (range 9–67) days for the COF group versus 11 (8–49) days for the EOF group (P < 0.001). Conclusion EOF provides a significant reduction in the length of the postoperative hospital stay without an increased complication risk after rectosigmoid resection with anastomosis as a part of cytoreductive surgery for primary ovarian cancer.

scholarly journals Early oral Feeding is Safe and Useful after Rectosigmoid Resection with Anastomosis During Cytoreductive Surgery for Primary Ovarian Cancer

2020 ◽  
Author(s):  
Kazuyoshi Kato ◽  
Kohei Omatsu ◽  
Sanshiro Okamoto ◽  
Maki Matoda ◽  
Hidetaka Nomura ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Cytoreductive Surgery ◽  
Group Versus ◽  
Postoperative Hospital Stay ◽  
Oral Feeding ◽  
Early Oral Feeding ◽  
Rectosigmoid Resection ◽  
Primary Ovarian Cancer

Abstract BackgroundThe aim of this study was to investigate the safety and clinical usefulness of early oral feeding (EOF) after rectosigmoid resection with anastomosis for the treatment of primary ovarian cancer.MethodsWe performed a retrospective review of all consecutive patients who had undergone rectosigmoid resection with anastomosis for primary ovarian, tubal, or peritoneal cancer during a 7-year period. Patient-related, disease-related, and surgery-related data including the incidence of anastomotic leakage and postoperative hospital stay were collected. EOF was introduced as a postoperative oral feeding protocol during the middle of the study period. Before the introduction of EOF, conventional oral feeding (COF) had been used.ResultsTwo hundred and one patients who underwent rectosigmoid resection with anastomosis, comprised of 95 patients in the COF group and 106 patients in the EOF group, were included in this study. The median number of postoperative days until the start of diet intake was 5 (range: 2–8) in the COF group and 2 (range: 2–8) in the EOF group (P < 0.001). Postoperative morbidity was equivalent between the groups. The incidence of anastomotic leakage was similar (1%) in both groups. The median length of the postoperative hospital stay was reduced by 6 days for the EOF group: 17 (range: 9–67) days for the COF group versus 11 (8–49) days for the EOF group (P < 0.001).ConclusionEOF provides a significant reduction in the length of the postoperative hospital stay without an increased complication risk after rectosigmoid resection with anastomosis as a part of cytoreductive surgery for primary ovarian cancer.

Predictive and Prognostic Implication of Bowel Resections During Primary Cytoreductive Surgery in Advanced Epithelial Ovarian Cancer

2018 ◽  
Vol 28 (9) ◽  
pp. 1664-1671 ◽  
Author(s):  
Thomas Bartl ◽  
Richard Schwameis ◽  
Anton Stift ◽  
Thomas Bachleitner-Hofmann ◽  
Alexander Reinthaller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ovarian Cancer ◽  
Overall Survival ◽  
Anastomotic Leakage ◽  
Cytoreductive Surgery ◽  
Large Bowel ◽  
Bowel Resection ◽  
Prognostic Implication ◽  
Rectosigmoid Resection ◽  
Advanced Epithelial Ovarian Cancer

ObjectivesThe aims of this study were to assess anastomotic leakage (AL) rate and risk factors for AL in patients with advanced epithelial ovarian cancer (EOC) undergoing cytoreductive surgery including bowel resections and to evaluate the prognostic implication of AL.MethodsData of 350 consecutive patients with International Federation of Gynecology and Obstetrics EOC stage IIB–IV who underwent cytoreductive surgery at the Department of General Gynecology and Gynecologic Oncology of the General Hospital of Vienna between 2003 and 2017 were collected. Within this cohort, 192 patients (54.9%) underwent at least 1 bowel resection and were further analyzed. Preoperative risk factors for AL were computed using logistic regression models. Prognostic factors for overall survival were evaluated by using log-rank tests and multivariable Cox regression model.ResultsOverall, the AL rate was 4.7% for patients with advanced EOC undergoing cytoreductive surgery with at least 1 bowel resection, including patients with multiple large bowel resections. The AL rate for patients with isolated rectosigmoid resection was 1.9%. In univariate analysis, the number of anastomoses per surgery (P= 0.04) was associated with the occurrence of AL. In multivariable analysis, rectosigmoid resection with additional large bowel resection was associated with a higher risk of AL compared with isolated rectosigmoid resection (P= 0.046; odds ratio, 7.23 [95% confidence interval, 1.04–50.39]). Anastomotic leakage was associated with decreased overall survival (P= 0.04) in univariate but not in multivariable survival analysis.ConclusionsAnastomotic leakage rate after rectosigmoid resection in advanced EOC is acceptably low and outweighs increased perioperative risks when performed in a high-volume institution. Nonetheless, the occurrence of AL is a severe adverse event, which even seems to negatively affect patients’ overall prognosis. As no factor could be identified to clearly predict AL, extensive procedures comprising multiple bowel resections, should be avoided particularly when complete resection cannot be achieved.

scholarly journals Early versus delayed oral feeding post total laryngectomy and relation to trachea-oesophageal fistula formation

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H A Elibiary ◽  
T A Aboelezz ◽  
O M Mady ◽  
A O T Keshk
Keyword(s):  
Hospital Stay ◽  
Total Laryngectomy ◽  
Malignant Tumors ◽  
Group Versus ◽  
Oral Feeding ◽  
Fistula Formation ◽  
Voice Rehabilitation ◽  
Pharyngocutaneous Fistula ◽  
Early Oral Feeding ◽  
Feeding Group

Abstract Background total laryngectomy is the most common procedure in treatment of advanced laryngeal malignant tumors. Total laryngectomy although an important and reliable method of management, still carries a lot of short term and long term complications. One of the common complications is the pharyngocutaneous fistula. Being a major risk factor of longer hospital stay, morbidity and wound infection. Pharyngocutaneous fistula is studied carefully concerning causes, risk factors and management. Oral feeding and voice rehabilitation are two valuable outcomes for the patient. Both could be disturbed by occurrence of pharyngocutaneous fistula. Oral feeding usually starts by the seventh to tenth day postoperative to allow adequate time for pharyngeal closure as believed by many surgeons for decades. Recent studies including our study discuss the possibility of early oral feeding versus conventional delayed feeding and its advantages regarding hospital stay and incidence of fistula. Aim The aim of this study is to points out the rate of pharyngocutaneous fistulae incidence after total laryngectomy in two different groups of patients depending on timing of post-operative oral feeding. Oral feeding usually starts after 7-10 days of surgery to allow for complete healing and closure of pharyngeal repair. Methodology A meta-analysis study is done to assess the feasibility and the possibility of early oral feeding after total laryngectomy versus delayed oral feeding. The outcome is the occurrence of pharyngocutaneous fistula in each group. Results In all included studies the incidence of pharyngocutaneous fistula was 168/1374 (12.23%) in early feeding group versus 69/570 (12.11%) in the delayed feeding group. The statistical difference was insignificant P &gt; 0.05 Conclusion Early oral feeding after total laryngectomy during the first 72 hours post-operative is a safe clinical practice and results in shorter hospital stay.

scholarly journals Effects of a stepwise, local patient-specific early oral feeding schedule after gastric cancer surgery: a single-center retrospective study from China

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ji Chen ◽  
Ming Xu ◽  
Yunpeng Zhang ◽  
Chun Gao ◽  
Peng Sun
Keyword(s):  
Gastric Cancer ◽  
Hospital Stay ◽  
Gastric Surgery ◽  
Postoperative Hospital Stay ◽  
Oral Feeding ◽  
Chinese Patients ◽  
Patient Specific ◽  
Feeding Schedule ◽  
Early Oral Feeding ◽  
Eras Protocol

Abstract Nowadays, early oral feeding after gastrectomy has been gradually accepted and applied in the clinical practice, but there is still no specific uniform feeding regimen available which works best for patients in different regions with different races and eating habits. Aiming to establish an early oral feeding schedule suitable for local Chinese patients after gastric surgery, from May 2014 to May 2018, 87 gastric cancer patients undergoing various types of gastric resections were enrolled in an early feeding protocol and their clinical course was reviewed retrospectively. A stepwise, local patient-specific, early oral feeding schedule was proposed, implemented within an early recovery after surgery (ERAS) protocol and accessed in terms of its safety and tolerability. The primary surgical outcomes included: a median (interquartile range; IQR) postoperative hospital stay of 6 (3) days; 67 (77%) patients were well tolerant of this schedule from postoperative day (POD) 1 to POD 4; 20 (23%) patients had mild I/II grade complications (Clavien-Dindo classification); 3 (3%) patients had IIIB complications, zero cases of hospital mortality. Compared to similar studies in the past, our early oral feeding program is also safe and beneficial, and it can shorten the postoperative hospital stay without causing any increase in postoperative complications. In summary, our work herein reported the establishment of a detailed early oral feeding schedule embedded within an ERAS protocol which was found to be suitable for local Chinese patients after gastric surgery. Accordingly, this early oral feeding schedule is worth further research and promotion.

The effect of early oral feeding after esophagectomy on the incidence of anastomotic leakage: an updated review

2020 ◽  
Vol 132 (5) ◽  
pp. 419-425
Author(s):  
Chu Zhang ◽  
Miao Zhang ◽  
Longbo Gong ◽  
Wenbin Wu
Keyword(s):  
Anastomotic Leakage ◽  
Oral Feeding ◽  
Early Oral Feeding

PS01.148: UTILITY OF GASTROSTOMY VIA GASTRIC TUBE AFTER ESOPHAGEAL CANCER SURGERY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 91-91
Author(s):  
Yoshihisa Matsumoto
Keyword(s):  
Esophageal Cancer ◽  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Gastric Tube ◽  
Postoperative Hospital Stay ◽  
Cancer Surgery ◽  
Recurrent Nerve ◽  
Clinicopathological Factors ◽  
Respiratory Complications ◽  
Postoperative Results

Abstract Background Esophageal cancer patients often suffer from preoperative malnutrition. It is very important for them to improve their perioperative nutrition status. In our department, we have adopted jejunostomy after esophageal cancer surgery in almost all cases. However, sometimes we have experienced catheter related complications via jejunostomy. Recently, several studies reported that gastrostomy via gastric tube might reduce the catheter related complications. In this study, we compared gastrostomy with jejunostomy as postoperative results and catheter related complications. Methods From January 2010 to November 2016, we performed 215 consecutive esophagectomy for esophageal cancer. It was divided into 133 cases of gastrostomy group (group G) and 82 cases of jejunostomy group (group J). We analyzed clinicopathological factors (age, sex, tumor localization, tumor progression degree and preoperative chemotherapy), postoperative results (anastomotic leakage, respiratory complications, recurrent nerve palsy and postoperative hospital stay) and correlation of catheter related complications retrospectively. Results There were no significant differences between the two groups in clinicopathological factors and postoperative outcomes such as anastomotic leakage, recurrent nerve paralysis and postoperative hospital stay. Respiratory complications were occurred in 12 cases (8.0%)/25 cases (31.0%) (P < 0.001). Catheter related complications were occurred in 17 cases (5 in group G (3.0%), 12 in group J (9.8%) (P = 0.005) and it was significantly less in group G. The details of catheter related complications were classified into group G (duodenal perforation and dislocation) and group J (intestinal perforation, intestinal obstruction and intestinal fluid leakage). Conclusion The rate of catheter related complications after esophagectomy via gastrostomy in this study were lower than that via jejunostomy in previous reports. We suggest the route of enteral nutrition via gastric tube is more effective than that via jejunostomy with regard to catheter related complications. Disclosure All authors have declared no conflicts of interest.

scholarly journals Fast Track Recovery Surgery with A Whey Protein Infused Carbohydrate Loading Drink Pre-Operatively and Early Oral Feeding Post-Operatively among Surgical Gynaecologic Cancer Patients: Study Protocol of an Open Labelled Randomised Controlled Trial

2019 ◽  
Author(s):  
Chiou Yi Ho ◽  
Zuriati Ibrahim ◽  
Zalina Abu Zaid ◽  
Zulfitri 'Azuan Mat Daud ◽  
Nor Baizura Md Yu
Keyword(s):  
Hospital Stay ◽  
Cancer Patients ◽  
Whey Protein ◽  
Intervention Group ◽  
Oral Feeding ◽  
Control Group ◽  
Bowel Sound ◽  
Early Oral Feeding ◽  
Carbohydrate Loading ◽  
Gynaecologic Cancer

Abstract Introduction: There has been growing evidence on the favourable outcomes of fast tract recovery (FTR) surgery; expedite recovery, minimise complications, reduce length of hospital stay on surgical patients. However, there is lack of evidence on the effectiveness of FTR in surgical gynaecologic cancer patients. Most of previous study did not focus on feeding composition in FTR surgery protocol. This study aims to determine the effectiveness of FTR feeding with whey protein infused carbohydrate loading drink pre-operatively and early oral feeding post-operatively on post-operative outcomes among surgical gynaecologic cancer patients. Methods and analysis: This open labelled RCT will randomly allocate patients into intervention and control group. Ambulated Malaysian aged over 18 years and scheduled for elective surgery for (suspected) GC, will be included in this study. Intervention group will be given whey protein infused carbohydrate loading drinks evening before operation and 3 hours before operation as well as started on early oral feeding 4 hours post-operatively. Control group will be fasted overnight pre-operation and only allowed plain water, and the diet transition fashion is followed when there is bowel sound post-operatively. Primary outcomes of study are length of post-operative hospital stay, length of clear fluid toleration, solid food toleration and bowel function. Additional outcome measures are changes in nutritional status, biochemical profile and functional status. Data will be analysed on an intention-to-treat basis. Trial Registration Number: ClinicalTrials.gov, NCT03667755. Registered 12 September 2018 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03667755

scholarly journals Comparison of early versus late enteral feeding following gut anastomosis.

2020 ◽  
Vol 27 (12) ◽  
pp. 2548-2552
Author(s):  
Zohra Jabeen ◽  
Ramlah Ghazanfor ◽  
Muhammad Usman Akram ◽  
Sara Malik ◽  
Maham Tariq ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Enteral Feeding ◽  
Oral Feeding ◽  
P Value ◽  
Age Group ◽  
Bowel Sounds ◽  
Early Oral Feeding ◽  
Group A ◽  
Group B ◽  
Mean Time

Objectives: To compare early feeding versus late enteral feeding following gut anastomosis in term of hospital stay. Study Design: Prospective Randomized Control study. Setting: Surgical Unit 1, Holy Family Hospital, Rawalpindi. Period: April to October 2017. Material & Methods: All patients, excluding paediatric age group (n= 60) undergoing emergency or non-emergency gut resection with primary anastomosis were incorporated. Two strata were devised. Group A (n=30) received early enteral feeding starting at 12th post-operative hours in form of 100-150ml fluid thrice daily. Group B endured being Nil per oral for 72hrs. Both groups were correlated for timing of return of bowel sounds and timespan of hospital stay. P value < 0.05 was considered noteworthy. Results: Overall 60 patients with 30 in each group were incorporated. They were predominantly males (55%) and belonged to middle age group (Group A=31.73+10.78 years; Group B= 36.00+10.53 years). Mean time for return of bowel sounds in both the groups was 24.40+5.88 hours and 35.20+10.88 hours respectively, which was striking (p value <0.05). Mean length of hospital stay in both the groups was also noteworthy i.e. 5.23+0.72 days and 6.40+1.67 days respectively. Conclusion: In the wake of gut anastomosis, early oral feeding at 12hours is superior to delayed oral feeding after 72hours, in terms of mean time for return of bowel sounds and period of hospital stay.

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