Inicio De Dieta Temprana Versus Dieta Tardía En El Postoperatorio De Pacientes Con Histerectomía Abdominal.
[Early versus late postoperative diet in patients with abdominal hysterectomy]

Cesar A. Reyes M, Rodolfo Andrino, Sobeyda K. López, Edward Herrera, Indiana Talavera, Alfredo Beitia, Douglas Jarquin

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Objetivo: comparar beneficios y complicaciones de la administracion temprana de dieta en el postoperatorio de pacientes con histerectomía abdominal. Metodología: Ensayo clínico aleatorizado, multicéntrico, participaron seis hospitales de la región centroamericana, se calculó muestra de 340 pacientes en base al número total de histerectomías en los hospitales participantes; 289 mujeres a quienes se realizó histerectomía fueron enroladas en el estudio, 155 asignadas a la intervención de dieta temprana y 134 al grupo de dieta tardía.Se realizaron tablas de frecuencias, análisis bivariado y multivariado, para la prueba de hipótesis se utilizó U de Mann Whitney. Resultados: Se presentaron características sociodemográficas similares, edad promedio Rango de 45-47 años, la presencia de ruidos intestinales fue 8 horas en promedio en el grupo de dieta temprana y 9 horas el grupo de dieta tardía, la primera evacuación se presentó a las 19.3 horas el grupo de dieta temprana y a las 27.4 horas el grupo de dieta tardía; en el grupo de dieta temprana se presentó entre las complicaciones vómitos con un RR 3.16 Conclusiones:las mujeres a quienes se les administró una dieta temprana presentan un retorno más rápido de la función intestinal, lo que puede repercutir en la mejoría post operatoria y no incrementa el aparecimiento de la distención abdominal.

Palabras Clave: cuidado postoperatorio, histerectomía, dieta, motilidad gastrointestinal

Abstract

Objective: to compare benefits and complications of early administration of diet in the postoperative period of patients with abdominal hysterectomy. Methodology: Multicenter randomized clinical trial, six hospitals from Central American region participated, a sample of 340 patients was calculated based on the total number of hysterectomy in the participating hospitals; 289 women who underwent hysterectomy were enrolled in the study, 155 assigned to the early diet intervention and 134 to the late diet group. Frequency tables, bivariate and multivariate analysis were made, for the hypothesis test, Mann Whitney U was used. Results: Similar sociodemographic characteristics were presented, average age range of 45-47 years. The presence of intestinal noises was 8 hours on average in the early diet group and 9 hours in the late diet group. The first evacuation occurred at 19.3 hours the early diet group and at 27.4 hours the late diet group. In the early diet group, the most frequent complication was vomiting, with a RR 3.16 Conclusions: women who were given an early diet have a faster return of bowel function, which can have an impact on post-operative improvement and does not increase the appearance of abdominal distention.

 Key words: Postoperative care, hysterectomy, diet, gastrointestinal motility.

 


Referencias


ACOG Committee Opinion No. 750: Perioperative Pathways: Enhanced Recovery After Surgery. ObstetGynecol, Sept 2018;132(3): e120-e130.

Johnson BE, Porter J. Preoperative evaluation of the gynecologic patient: considerations for improved outcomes. ObstetGynecol, 2008 May;111(5):1183-94.

DemirayakG, AykutÖzdemir I, Comba C, AslanÇetin B, AydoganMathyk B, Yıldız M et al. Comparison of laparoendoscopic single-site (LESS) surgery and conventional multiport laparoscopic (CMPL) surgery for hysterectomy: long-term outcomes of abdominal incisional scar. Journal of Obstetrics and Gynaecology, 2020;40:2,217-221.

Dowdy S, Kalogera E, Scott M. Optimizing Preanesthesia Care for the Gynecologic Patient. ObstetGynaecol 2019; 134:395-408.

Ballard AC, Parker CY, Markland A, Varner RE, HuisinghC, RitcherHC. Bowel preparation before vaginal prolapse surgery: a randomized controlled trial.ObstetGynecol. 2014 Feb;123(2 Pt 1):232-8.

Won H, Maley , Salim S, Rao A, Campbell NT, Abbott JA. Surgical and patient outcomes using mechanical bowel preparation before laparoscopic gynecologic surgery: a randomized controlled trial.Obstet Gynecol. 2013 Mar;121(3):538-46.

Carey ET, Moulder JK. Perioperative Management and Implementation of Enhanced Recovery Programs in Gynecologic Surgery for Benign Indications.Obstet Gynecol. 2018 Jul;132(1):137-146.

Modesitt SC, Sarosiek BM, Trowbridge ER, Redick DL, Shah PM, Thiele RH, Tiouririne M, Hedrick TL.Enhanced Recovery Implementation in Major Gynecologic Surgeries: Effect of Care Standardization. ObstetGynecol. 2016 Sep;128(3):457-66.

Balayla J, Bujold E, Lapensée L, Mayrand MH, Sansregret A. Early Versus Delayed Postoperative Feeding After Major Gynaecological Surgery and its Effects on Clinical Outcomes, Patient Satisfaction, and Length of Stay: A Randomized Controlled Trial. J ObstetGynaecol Can. 2015 Dec;37(12):1079-85.

Cutillo G, Maneschi F, Franchi M, Giannice R, Scambia G, Benedetti-Panici P. Early feeding compared with nasogastric decompression after major oncologic gynecologic surgery: a randomized study. ObstetGynecol. 1999 Jan;93(1):41-5.

Dua M, Navalgund A2, Axelrod S, Axelrod L, Worth PJ, Norton JA, Poultsides GA, Triadafilopoulos G, Visser BC.Monitoring gastric myoelectric activity after pancreaticoduodenectomy for diet "readiness". Am J PhysiolGastrointest Liver Physiol. 2018 Nov 1;315(5):G743-G751.

Bolton JS, Conway WC, Abbas AE.Planned delay of oral intake after esophagectomy reduces the cervical anastomotic leak rate and hospital length of stay.J Gastrointest Surg. 2014 Feb;18(2):304-9.

Wright JD, Huang Y, Melamed A, Tergas AI, St Clair CM, Hou JY, Khoury-Collado F et al. Use and Misuse of Opioids After Gynecologic Surgical Procedures. Obstet Gynecol. 2019 Aug;134(2):250-260.

Pan Y, Chen L, Zhong X, Feng S. Gum chewing combined with oral intake of a semi-liquid diet in the postoperative care of patients after gynaecologic laparoscopic surgery. J ClinNurs. 2017 Oct;26(19-20):3156-3163.

Veiga-Gil L, Pueyo J, López-Olaondo L. Náuseas y vómitos postoperatorios: fisiopatología, factores de riesgo, profilaxis y tratamiento. Rev. española de anestesia y reanimación, 2016; 64(4):223-232

Hogan S, Steffens D, Rangan A, Salomon M, Carey S.The effect of diets delivered into the gastrointestinal tract on gut motility after colorectal surgery-a systematic review and meta-analysis of randomised controlled trials. Eur J ClinNutr. 2019 Oct;73(10):1331-1342.

Kim JW, Park YG, Kim JH, Jang EC, Ha YC. The Optimal Time of Postoperative Feeding After Total Hip Arthroplasty: A Prospective, Randomized, Controlled Trial. ClinNurs Res. 2020 Jan;29(1):31-36.

Jia W, Liu W, Quiao X. Chinese Expert Consensus on Enhanced Recovery AfterHepatectomy. AsianJournal of Surg, 2019; 42: 11-18

MohsinaS, Shanmugam D, Sureshkumar S, Kundra P, Mahalakshmy T, Kate V. Adapted ERAS Pathway vs. Standard Care in Patients with Perforated Duodenal Ulcer-a Randomized Controlled Trial. J Gastrointest Surg. 2018 Jan;22(1):107-116.




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Revista de la Federación Centroamericana de Asociaciones y Sociedades de Obstetricia y Ginecología. Editorial Infomedic International ISSN: 0428-0911 e-ISSN:2710-7604   - Soporte técnico