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

Kemal Güngördük; Berfin Selimoğlu; Varol Gülseren; Eylem Yasar; Cihan Comba; İsa Aykut Özdemir

doi:10.1002/ijgo.15181

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

Int J Gynaecol Obstet. 2024 Mar;164(3):1108-1116. doi: 10.1002/ijgo.15181. Epub 2023 Oct 6.

Authors

Kemal Güngördük¹, Berfin Selimoğlu², Varol Gülseren³, Eylem Yasar⁴, Cihan Comba⁵, İsa Aykut Özdemir⁶

Affiliations

¹ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
² Department of Obstetrics and Gynecology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
³ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.
⁴ Department of Anesthesiology and Reanimation, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
⁵ Division of gynecologic Oncology, Department of Obstetrics and Gynecology, Bakırköy Sadi Konuk Education and Research Hospital, İstanbul, Turkey.
⁶ Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medipol University, İstanbul, Turkey.

PMID: 37800343
DOI: 10.1002/ijgo.15181

Abstract

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.

Keywords: gynecological malignancy; gynecological oncology surgeries; hot water pack; postoperative hospital stay; postoperative ileus; surgery.

Publication types

Randomized Controlled Trial

MeSH terms

Abdomen
Female
Flatulence* / complications
Gastrointestinal Motility
Gynecologic Surgical Procedures / adverse effects
Humans
Ileus* / etiology
Postoperative Complications / epidemiology
Postoperative Complications / prevention & control
Recovery of Function
Water

Substances

Water

Associated data

ClinicalTrials.gov/NCT04833699