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

Introduction: 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.

Method: 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).

Conclusion: 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.