Effect of abdominal hot pack application on gastrointestinal motility recovery after comprehensive gynecologic staging surgery

Güngördük K., Selimoğlu B., GÜLSEREN V., Yasar E., Comba C., ÖZDEMİR İ. A.

International Journal of Gynecology and Obstetrics, cilt.164, sa.3, ss.1108-1116, 2024 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 164 Sayı: 3
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1002/ijgo.15181
  • Dergi Adı: International Journal of Gynecology and Obstetrics
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL, EMBASE, Gender Studies Database, Public Affairs Index
  • Sayfa Sayıları: ss.1108-1116
  • Anahtar Kelimeler: gynecological malignancy, gynecological oncology surgeries, hot water pack, postoperative hospital stay, postoperative ileus, surgery
  • Erciyes Üniversitesi Adresli: Evet

Özet

Objective: To evaluate whether abdominal hot water pack application improves gastrointestinal motility following gynecological oncology surgery. Methods: The study was registered at ClinicalTrials.gov (NCT04833699). (https://clinicaltrials.gov/ct2/show/NCT04833699?cond=NCT04833699&draw=2&rank=1). In this randomized controlled trial, participants were randomly assigned (1:1) to the hot water pack group (standardized enhanced recovery protocols plus rubber water bag with a fluffy cover filled with boiled tap water [80°C] and placed on the abdomen at 3, 6, 9, and 12 h postoperatively for 30 min each time) or the control group (standardized enhanced recovery protocols). A subumbilical or supraumbilical vertical midline incision was made to perform staging surgery procedures, including hysterectomy, salpingo-oophorectomy with retroperitoneal lymphadenectomy. The primary outcome was the time to first passage of flatus from the end of the staging procedure. Results: In total, 121 women were randomized to the control (n = 62) or hot water pack (n = 59) group. The use of an abdominal hot water pack significantly reduced the mean time to passing first flatus (25.2 ± 3.6 vs. 30.6 ± 3.9 h; hazard ratio [HR] = 4.4; 95% confidence interval [CI]: 2.8–7.1; P < 0.0001), mean time to first bowel movements (28.4 ± 4.0 vs. 34.4 ± 4.5 h; HR = 4.9; 95% CI: 3.0–7.9; P < 0.0001), mean time to first defecation (33.4 ± 4.9 vs. 41.0 ± 7.6 h; HR = 4.3; 95% CI: 2.1–6.8; P < 0.0001), and mean time to tolerating solid diet (2.1 ± 0.6 vs. 2.8 ± 1.0 days; HR = 4.4; 95% CI: 2.2–8.7; P < 0.0001) compared to the control group. The postoperative ileus incidence was significantly lower in the hot water pack group (3.4%) than the control group (16.1%) (P = 0.01). Conclusion: Abdominal hot water pack application improved gastrointestinal function recovery in women following surgical staging procedures for gynecological malignancy.