Güngördük Kemal, Özdemir İsa Aykut, Güngördük Özgü, Gülseren Varol, Gokçü Mehmet, Sancı Muzaffer
Department of Gynecologic Oncology, Muğla Sıtkı Koçman University, Education and Research Hospital, Muğla, Turkey.
Department of Gynecologic Oncology, Bakırköy Dr Sadi Konuk Education and Research Hospital, İstanbul, Turkey.
Am J Obstet Gynecol. 2017 Feb;216(2):145.e1-145.e7. doi: 10.1016/j.ajog.2016.10.019. Epub 2016 Oct 22.
Paralytic ileus that develops after elective surgery is a common and uncomfortable complication and is considered inevitable after an intraperitoneal operation.
The purpose of this study was to investigate whether coffee consumption accelerates the recovery of bowel function after complete staging surgery of gynecologic cancers.
In this randomized controlled trial, 114 patients were allocated preoperatively to either postoperative coffee consumption with 3 times daily (n=58) or routine postoperative care without coffee consumption (n=56). Total abdominal hysterectomy and bilateral salpingo-oophorectomy with systematic pelvic and paraaortic lymphadenectomy were performed on all patients as part of complete staging surgery for endometrial, ovarian, cervical, or tubal cancer. The primary outcome measure was the time to the first passage of flatus after surgery. Secondary outcomes were the time to first defecation, time to first bowel movement, and time to tolerance of a solid diet.
The mean time to flatus (30.2±8.0 vs 40.2±12.1 hours; P<.001), mean time to defecation (43.1±9.4 vs 58.5±17.0 hours; P<.001), and mean time to the ability to tolerate food (3.4±1.2 vs 4.7±1.6 days; P<.001) were reduced significantly in patients who consumed coffee compared with control subjects. Mild ileus symptoms were observed in 17 patients (30.4%) in the control group compared with 6 patients (10.3%) in the coffee group (P=.01). Coffee consumption was well-tolerated and well-accepted by patients, and no intervention-related side-effects were observed.
Coffee consumption after total abdominal hysterectomy and systematic paraaortic lymphadenectomy expedites the time to bowel motility and the ability to tolerate food. This simple, cheap, and well-tolerated treatment should be added as an adjunct to the postoperative care of gynecologic oncology patients.
择期手术后发生的麻痹性肠梗阻是一种常见且令人不适的并发症，被认为在腹腔手术后不可避免。
本研究旨在调查饮用咖啡是否能加速妇科癌症根治性分期手术后肠道功能的恢复。
在这项随机对照试验中，114例患者术前被随机分为术后饮用咖啡组（每日3次，n = 58）和术后常规护理不饮用咖啡组（n = 56）。所有患者均接受全腹子宫切除术、双侧输卵管卵巢切除术及系统性盆腔和腹主动脉旁淋巴结清扫术，作为子宫内膜癌、卵巢癌、宫颈癌或输卵管癌根治性分期手术的一部分。主要观察指标为术后首次排气时间。次要观察指标为首次排便时间、首次肠蠕动时间和耐受固体食物的时间。
与对照组相比，饮用咖啡的患者排气平均时间（30.2±8.0 vs 40.2±12.1小时；P<0.001）、排便平均时间（43.1±9.4 vs 58.5±17.0小时；P<0.001）和耐受食物能力的平均时间（3.4±1.2 vs 4.7±1.6天；P<0.001）均显著缩短。对照组有17例患者（30.4%）出现轻度肠梗阻症状，而咖啡组有6例患者（10.3%）出现该症状（P = 0.01）。患者对饮用咖啡耐受性良好且接受度高，未观察到与干预相关的副作用。
全腹子宫切除术后及系统性腹主动脉旁淋巴结清扫术后饮用咖啡可加快肠道蠕动时间和耐受食物的能力。这种简单、廉价且耐受性良好的治疗方法应作为妇科肿瘤患者术后护理的辅助措施。
