Management of Gastrointestinal Function in Patients After Laparoscopic Surgery for Benign Gynaecological Diseases: A Best Practice Implementation Project.
Mengdan Zhou, Aiping Fu, Shuixian Zhang and 1 others
PMID 41906267WHAT IT FOUND
Shorter first flatus and defecation times and less abdominal distension were reported with a ward-based perioperative bundle after laparoscopic gynaecological surgery, but many measures were delivered together, so no single component can be credited.
Key findings
01After implementation, time to first anal discharge was 12.52 h in the follow-up group and 21.51 h in the baseline group (p < 0.001).
02After implementation, time to first defecation was 42.18 h in the follow-up group and 50.47 h in the baseline group (p = 0.003).
03The follow-up group had 25 patients with no abdominal distension and 5 with moderate distension, while the baseline group had 18 with no distension and 9 with moderate distension (p = 0.010).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single-site audit before and after implementation, so it does not prove the bundle caused the improvement. Many interventions were introduced together, including fasting rules, carbohydrate drink, gum, coffee, walking, positioning, early diet, analgesia and acupoint massage, so the effect of any one component cannot be separated. The study period was short and the sample was 90 patients, so results may not apply to other hospitals or to patients with more complex disease. Some criteria were poorly followed, especially knee-chest positioning, which stayed at 6.67%. Gastrointestinal recovery was judged by symptoms and timing, not by laboratory biomarkers.
Declared interests
Funded by the Zhejiang Medical Health Science and Technology Project. The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that nurse training or any single measure such as acupoint massage, chewing gum or coffee caused the shorter time to first flatus and defecation. The study compared a baseline audit period with a follow-up audit period after a bundle of many interventions, so the contribution of any single component cannot be separated.