The incidence of postprandial nausea and nutritional regression in gynecologic cancer patients following intestinal surgery: A retrospective cohort study

• Postoperative oral feeding is often initiated once bowel functioning resumes.
• Patients who prematurely commence oral feeding may be at risk for postprandial nausea.
• Delayed feeding may address this concern but patient hospital stay may be prolonged.

IntroductionWe 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.MethodThe 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.ResultsThere 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).ConclusionEarly 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.