title: The incidence of postprandial nausea and nutritional regression in gynecologic cancer patients following intestinal surgery: a retrospective cohort study.
abstract: BACKGROUND
  We sought to evaluate the impact of defined intestinal surgeries on postprandial nausea, nutritional regression (i.e., a soft diet that was altered to clear liquids) and hospital stay duration in a population of gynecologic cancer patients.
  
  
  METHODS
  The following study variables were evaluated: age, intestinal surgery type: 1) small bowel resection (SBR) 2) proximal colectomy alone (Col) 3) rectosigmoid resection (RSR) and 4) rectosigmoid resection with proximal colectomy (RSR + Col), initiation of postoperative feeding (period 1 = days 1 or 2, period 2 = days 3 or 4, or period 3 ≥ day 5), development of postprandial nausea, incidence of nutritional regression and hospital stay duration.
  
  
  RESULTS
  There were 218 patients who were the subject of this study. Patients who initiated early feeding (i.e., period 1) were at significantly greater risk for developing postprandial nausea (P = 0.005); the subjects in the RSR and RSR + Col groups had the highest incidence of postprandial nausea (P = 0.008). Also, in the combined group of patients, those who were fed the latest (i.e., period 3 or ≥5 days) had the longest hospital stay (P < 0.001).
  
  
  CONCLUSIONS
  Early postoperative feeding is presumably safe but postprandial nausea and nutritional regression may be a concern in these patients who have undergone an extensive intestinal surgery. Delayed feeding may mitigate the incidence of postprandial nausea and nutritional regression although potentially at the expense of increased hospital stay duration.
authors: Gynecologic Oncology Associates, 351 Hospital Road, Suite #507, Newport Beach, CA 92663, USA.
authors: Mark A
authors: MA
authors: Rettenmaier
authors: Gynecologic Oncology Associates, 351 Hospital Road, Suite #507, Newport Beach, CA 92663, USA.
authors: Lisa N
authors: LN
authors: Abaid
authors: Gynecologic Oncology Associates, 351 Hospital Road, Suite #507, Newport Beach, CA 92663, USA.
authors: John V
authors: JV
authors: Brown
authors: Gynecologic Oncology Associates, 351 Hospital Road, Suite #507, Newport Beach, CA 92663, USA.
authors: Alberto A
authors: AA
authors: Mendivil
authors: Gynecologic Oncology Associates, 351 Hospital Road, Suite #507, Newport Beach, CA 92663, USA.
authors: John P
authors: JP
authors: Micha
authors: Gynecologic Oncology Associates, 351 Hospital Road, Suite #507, Newport Beach, CA 92663, USA. Electronic address: bram@gynoncology.com.
authors: Bram H
authors: BH
authors: Goldstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000009:adverse effects*; D004750:Enteral Nutrition; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007421:Intestine, Small / Q000601:surgery*; D007902:Length of Stay; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology*; D019518:Postprandial Period; D012189:Retrospective Studies; D013997:Time Factors
keywords: Early feeding; Gynecologic surgery; Intestinal surgery; Nausea