Efficiency Of Sham Feeding Combined With Modified Postoperative Diet Management For Women Undergoing Gynecological Laparoscopic Surgery

Objective:(1) To explore and evaluate the efficacy and safety of early semi-liquid oral intake following gynecologic laparoscopic surgery;(2) To explore and evaluate the efficacy and safety of sham feeding combined with early oral semi-liquid intake following gynecologic laparoscopic surgery.Methods:In accordance with the inclusion criteria and exclusion criteria,250patients, who underwent laparoscopic surgery in Huzhou Maternal and Child Health-Care Center from January of2014to November of2014, were enrolled in the study. Subjects were randomly assigned to chewing group, semi-liquid diet group or liquid diet group (control group) according to the order of admission. Subjects of the chewing group began to chew sugar-free gum when they are conscious and keep once every2hours with2-3tablets for10-15min each time, then start oral intake semi-liquid6hours after operation if no nausea happening and followed by normal diet after defecation. Subjects of semi-liquid diet group received semi-liquid diet as the first meal6hours after operation if they are conscious and had no complaints of nausea and vomiting and then followed by regular diet with presence of stool. Subjects allocated in the liquid group were traditionally progressed stepwise fashion beginning with liquid diet and then semi-liquid diet with passage flatus and lastly changed to regular diet if patients defecated. Diet foods were supplied only by the hospital. All the subjects were evaluated for nausea, vomiting, bowel sounds, passage of flatus, defecation, the feeling of hunger, abdominal distension, serum potassium value on postoperative day1, RBP value on postoperative day2.Results:(1) There were significant differences in the first time of auscultatory bowel sound, passage of flatus, bowel movement, presence of stool among three groups. The time of auscultatory bowel sound, passage of flatus, presence of stool were significantly shorter in chewing group than those in liquid groups (P<0.01), while the time of auscultatory bowel sound, passage of flatus, presence of stool were significantly shorter in semi-liquid group than those in liquid groups (P<0.05).(2) There was no case needing gastrointestinal decompression due to intestinal obstruction in the3groups. The incidence of hunger in chewing group and semi-liquid diet group were significantly lower than liquid diet group (P<0.05); No significant differences found in nausea and vomiting among the3groups (P>0.05);The incidence of abdominal distension in chewing group were significantly lower than semi liquid diet group and liquid diet group(P<0.05). (3) Eleven cases (14%) experienced low serum potassium on postoperative Day1and13cases (17%) experienced same problems in chewing group while25cases (32%) in liquid diet group. The incidence of low serum potassium in chewing group and semi-liquid group were significantly lower than those in the liquid diet group(P<0.05).(4) Significant differences in RBP value on postoperative day2were found among the three groups. RBP value on postoperative day2in chewing group were significantly higher than those in the semi-liquid diet group and liquid diet group(P<0.05).Conclusions:(1) Semi-liquid diet as the first meal6hours after operation for patient undergoing laparoscopic gynecological surgery showed superiority in bowel function recovery, nutrition status and the patients’ feeling.(2) Sham feeding combined with modified postoperative diet management (early oral intake semi-liquid)6hours after operation for women undergoing gynecological laparoscopic surgery were conducive to bowel function recovery and patients nutrition.(3) Sham feeding combined with modified postoperative diet management (early oral intake semi-liquid) or early oral intake semi-liquid6hours after operation for women undergoing gynecological laparoscopic surgery is safe and well-tolerated. The traditional diet management protocol for patients undergoing laparoscopic surgery is hopeful to be replaced.