Abstract
IntroductionThere has been growing evidence on the favourable outcomes of fast-track-recovery (FTR) surgery; to expedite recovery, minimise complications, and reduce the length of hospital stay for surgical patients. However, there is lack of evidence on the effectiveness of FTR in surgical gynaecological cancer (GC) patients. Most of the previous studies did not focus on feeding composition in the FTR surgery protocol. This study aims to determine the effectiveness of FTR feeding with a whey-protein-infused carbohydrate-loading drink pre-operatively and early oral feeding post-operatively on post-operative outcomes among surgical GC patients.Methods/designThis open-labelled, randomised controlled trial (RCT) will randomly allocate patients into intervention and control groups. Ambulated Malaysian aged over 18 years and scheduled for elective surgery for (suspected) GC, will be included in this study. The intervention group will be given whey-protein-infused carbohydrate-loading drinks on the evening before their operation and 3 h before their operation as well as started on early oral feeding 4 h post-operatively. The control group will be fasted overnight pre-operation and only allowed plain water, and return to a normal diet is allowed when bowel sounds return post-operatively. The primary outcomes of study are length of post-operative hospital stay, length of clear-fluid tolerance, solid-food tolerance and bowel function. Additional outcome measures are changes in nutritional status, biochemical profile and functional status. Data will be analysed on an intention-to-treat basis.Trial registrationClinicalTrials.gov, ID: NCT03667755. Retrospectively registered on 12 September 2018;Protocol version: version 3 dated 27 September 2017.
Highlights
There has been growing evidence on the favourable outcomes of fast-track-recovery (FTR) surgery; to expedite recovery, minimise complications, and reduce the length of hospital stay for surgical patients
Clinical care of patients undergoing gynaecological cancer (GC) surgery is different between hospitals and countries; it is necessary to understand the effectiveness of FTR surgery perioperative feeding in Malaysia
The FTR surgery programme in Malaysia has mostly been conducted in gastroenterology surgery and even in hepato-biliary surgery [29]
Summary
There has been growing evidence on the favourable outcomes of fast-track-recovery (FTR) surgery; to expedite recovery, minimise complications, and reduce the length of hospital stay for surgical patients. Many studies have highlighted the general FTR programme which includes providing patients solely with carbohydrate (CHO)-loading pre-operatively and allowing early oral feeding with clear fluid and followed by solid food only after 500 mL clear fluid is tolerated post-operatively [7,8,9,10]. Using a multi-modal stress-minimising approach has been shown repeatedly to reduce rates of morbidity, improve recovery and shorten length of hospital stay (LOS) after major colorectal surgery [13]. An updated consensus review of perioperative care of colorectal cancer patients has highlighted that the multimodal metabolic stress-minimising approach was demonstrated repeatedly to shorten LOS stay, promote recovery and reduce the morbidity rate after major colorectal surgery [14]. Clinical care of patients undergoing GC surgery is different between hospitals and countries; it is necessary to understand the effectiveness of FTR surgery perioperative feeding in Malaysia
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
