Impact of perioperative care on the post-operative recovery of women undergoing surgery for gynaecological tumours.
To assess perioperative care in patients undergoing abdominal surgery for gynaecological tumours and how it relates to post-operative (PO) complications and oral PO feeding. Ninety-one women undergoing major abdominal surgery for gynaecological tumours were enrolled. Data included mechanical bowel preparation (MBP), prescribed diet, length of fast, start date of oral diet and progression of food consistency, anaesthetic technique, use of opioids and intravenous hydration (IH). Outcomes evaluated were nausea, vomiting and abdominal distension. The median pre-operative length of fast was 11.4 h. PO digestive complications occurred in 46.2% of the patients. Median intraoperative total IH and crystalloids were significantly higher in patients with abdominal distension during the first and second PO day. MBP with mannitol implied greater intraoperative IH and was significantly associated with a higher incidence of immediate PO nausea. Post-operative IH was also associated with gastrointestinal complications. The best cut-off point for the cumulative fluid load PO for determining a longer PO hospital stay was 4 L. Performing MBP before surgery and excessive IH are factors related to major digestive complications in our study population. Changes in pre-operative fasting time and PO refeeding should be considered to reduce the gastrointestinal complications and PO recovery time.
University Center of Cancer Control, Pedro Ernesto University Hospital, Rio de Janeiro, Brazil.
D
D
Spitz
National Cancer Institute, Rio de Janeiro, Brazil.
G V
GV
Chaves
Josué de Castro Nutrition Institute, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
W A F
WAF
Peres
D000005:Abdomen; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000758:Anesthesia / Q000379:methods; D015331:Cohort Studies; D019092:Conization; D000077324:Crystalloid Solutions; D005215:Fasting; D005247:Feeding Behavior; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005767:Gastrointestinal Diseases / Q000453:epidemiology*; D005833:Genital Neoplasms, Female / Q000601:surgery*; D013509:Gynecologic Surgical Procedures; D006801:Humans; D007044:Hysterectomy; D007045:Hysterectomy, Vaginal; D015994:Incidence; D007552:Isotonic Solutions / Q000627:therapeutic use; D010535:Laparoscopy; D007902:Length of Stay; D008197:Lymph Node Excision; D008875:Middle Aged; D010052:Ovariectomy; D010388:Pelvis; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D020127:Recovery of Function; D013997:Time Factors
D000077324:Crystalloid Solutions; D007552:Isotonic Solutions
fluid therapy; gynaecological tumour; perioperative care; surgery