Summary of findings for the main comparison. Early oral feeding compared to delayed oral feeding for women who had major abdominal gynaecologic surgery.
| Early oral feeding compared to delayed oral feeding for women who had major abdominal gynaecologic surgery | ||||||
| Patient or population: Women who had major abdominal gynaecologic surgery Settings: University hospital/cancer centre Intervention: Early oral feeding Comparison: Delayed (traditional) oral feeding | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Delayed oral feeding | Early oral feeding | |||||
| Postoperative ileus | 77 per 1000 | 36 per 1000 (13 to 99) | RR 0.47 (0.17 to 1.29) | 279 (3 studies) | ⊕⊕⊕⊝ moderate1 | |
| Nausea or vomiting or both | 352 per 1000 | 363 per 1000 (225 to 588) | RR 1.03 (0.64 to 1.67) | 484 (4 studies) | ⊕⊕⊕⊝ moderate2 | Random effects model, deployed because of substantial heterogeneity between studies (I2> 50%) |
| Time to bowel sounds [days] | The mean time to the presence of bowel sound [days] in the intervention groups was 0.32 lower (0.61 to 0.03 lower) | 338 (2 studies) | ⊕⊕⊕⊝ moderate3 | Random effects model, deployed because of substantial heterogeneity between studies (I2> 50%) | ||
| Time to the passage of flatus [days] | The mean time to the passage of flatus [days] in the intervention groups was 0.21 lower (0.4 to 0.01 lower) | 444 (3 studies) | ⊕⊕⊕⊕ high | |||
| Time to the first solid diet [days] | The mean time to the first solid diet [days] in the intervention groups was 1.47 lower (2.26 to 0.68 lower) | 301 (2 studies) | ⊕⊕⊕⊝ moderate3 | Random effects model, deployed because of substantial heterogeneity between studies (I2> 50%) | ||
| Time to first passage of stool [days] | The mean time to first passage of stool [days] in the intervention groups was 0.25 lower (0.58 lower to 0.09 higher) | 249 (2 studies) | ⊕⊕⊕⊝ moderate3 | |||
| Hospital stay [days] | The mean hospital stay [days] in the intervention groups was 0.92 lower (1.53 to 0.31 lower) | 484 (4 studies) | ⊕⊕⊕⊝ moderate4 | Random effects model, deployed because of substantial heterogeneity between studies (I2> 50%) | ||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk ratio; | ||||||
| GRADE Working Group grades of evidence High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. | ||||||
1 For the three studies contributing data, all were at high risk of performance bias, two were at unclear risk of detection bias, and one was at high risk of selection bias (no allocation concealment). 2 For the four studies contributing data, all were at high risk of performance bias and unclear risk of detection bias. 3 This outcome may be influenced by the high risk of performance bias in the two studies that contributed data.
4 This outcome may be influenced by the high risk of performance bias in all studies that provided data.