Toptas Tayfun, Ureyen Isin, Kahraman Alper, Gokkaya Mustafa, Yalcin Necim, Alci Aysun, Kole Merve Cakir, Kandemi R Selim, Goksu Mehmet, Akgul Nedim, Dogan Selen
Department of Gynecologic Oncology, Saglik Bilimleri University Antalya Training and Research Hospital, Antalya 07100, Turkey.
Department of General Surgery, Saglik Bilimleri University Antalya Training and Research Hospital, Antalya 07100, Turkey.
Exp Ther Med. 2024 Mar 4;27(5):181. doi: 10.3892/etm.2024.12469. eCollection 2024 May.
Despite the theoretical benefits, the favorable effect of preoperative carbohydrate loading on postoperative morbidity remains controversial. Most of the outcomes reported in the literature are derived from non-gynecologic surgery data, with only one study involving a limited number of patients specifically in gynecological oncology. The present study aimed to investigate the impact of carbohydrate loading, as a single element of enhanced recovery after surgery protocols, on postoperative course and morbidity in patients undergoing debulking surgery for epithelial ovarian cancer (EOC). The present study was a non-randomized, prospective cohort trial enrolling patients with EOC who underwent surgery between June 2018 and December 2021. An oral carbohydrate supplement with a dose of 50 g was given to patients 2-3 h before anesthesia. Data on postoperative course and morbidity were collected and compared with data of a historical cohort including consecutive patients who underwent surgery without a carbohydrate loading between January 2015 and June 2018. Analyses were performed on a total of 162 patients, including 72 patients in the carbohydrate loading group and 90 patients in the control group. Median length of hospital stay (11 days vs. 11 days; P=0.555), postoperative days 1-7 serum c-reactive protein levels (P=0.213), 30-day readmission (11.6% vs. 11.5%, P=0.985), 30-day relaparotomy (2.8% vs. 3.4%, P=0.809) and 30-day morbidity (48.6% vs. 46.7%; P=0.805) were comparable between the cohorts. No significant differences in grades of morbidities were identified between the cohorts (P=0.511). Multivariate analysis revealed that the sole independent risk factor for any postoperative morbidity was operative time. In conclusion, based on the results of the present study, postoperative course and morbidity seemed to be unaffected by carbohydrate loading in patients undergoing debulking surgery for EOC.
尽管有理论上的益处，但术前碳水化合物负荷对术后发病率的有利影响仍存在争议。文献中报道的大多数结果来自非妇科手术数据，仅有一项研究专门涉及有限数量的妇科肿瘤患者。本研究旨在调查碳水化合物负荷作为术后加速康复方案的一个单一要素，对上皮性卵巢癌（EOC）减瘤手术患者术后病程和发病率的影响。本研究是一项非随机、前瞻性队列试验，纳入了2018年6月至2021年12月期间接受手术的EOC患者。在麻醉前2 - 3小时给患者服用一剂50克的口服碳水化合物补充剂。收集术后病程和发病率数据，并与一个历史队列的数据进行比较，该历史队列包括2015年1月至2018年6月期间连续接受无碳水化合物负荷手术的患者。对总共162例患者进行了分析，其中碳水化合物负荷组72例，对照组90例。两组之间的中位住院时间（11天对11天；P = 0.555）、术后第1 - 7天血清C反应蛋白水平（P = 0.213）、30天再入院率（11.6%对11.5%，P = 0.985）、30天再次剖腹手术率（2.8%对3.4%，P = 0.809）和30天发病率（48.6%对46.7%；P = 0.805）相当。两组之间发病率等级无显著差异（P = 0.511）。多因素分析显示，任何术后发病的唯一独立危险因素是手术时间。总之，基于本研究结果，对于接受EOC减瘤手术的患者，术后病程和发病率似乎不受碳水化合物负荷的影响。
