title: Safety and efficacy of immediate postoperative feeding and bowel stimulation to prevent ileus after major gynecologic surgical procedures.
abstract: BACKGROUND
  Postoperative ileus is a major complication of abdominal surgical procedures
  
  
  OBJECTIVE
  To evaluate the incidence of ileus and gastrointestinal morbidity in patients who received immediate postoperative feeding and bowel stimulation after undergoing major gynecologic surgical procedures.
  
  
  METHODS
  During a 5-year period, the authors tracked demographic, surgical outcome, and follow-up information for 707 patients who underwent major gynecologic operations. All patients received the same postoperative orders, including immediate feeding of a diet of choice and bowel stimulation with 30 mL of magnesium hydroxide (milk of magnesia) twice daily until bowel movements occurred.
  
  
  RESULTS
  Of 707 patients, 6 (<1%) had postoperative ileus. No patients experienced postoperative bowel obstruction and 2 patients (0.3%) had postoperative intestinal leak. No serious adverse effects associated with bowel stimulation were reported.
  
  
  CONCLUSIONS
  Immediate postoperative feeding and bowel stimulation is a safe and effective approach to preventing ileus in patients who undergo major gynecologic surgical procedures.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Pennsylvania State University, Milton S. Hershey Medical Center, 500 University Dr Room C-3620, Hershey, PA 17033-2360, USA. jfanning1@hmc.psu.edu
authors.forename: James
authors.initials: J
authors.lastname: Fanning
authors.forename: Rod
authors.initials: R
authors.lastname: Hojat
mesh_terms: D000082:Acetaminophen; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000762:Anesthesia Recovery Period; D002400:Cathartics / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D045823:Ileus / Q000209:etiology* / Q000517:prevention & control; D015994:Incidence; D020911:Ketorolac Tromethamine; D007902:Length of Stay; D008276:Magnesium Hydroxide / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009020:Morphine; D010098:Oxycodone; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002400:Cathartics; D000082:Acetaminophen; D020911:Ketorolac Tromethamine; D009020:Morphine; D010098:Oxycodone; D008276:Magnesium Hydroxide