A Cochrane review [Abstract] 1 included 5 studies with a total of 631 women. Rates of developing postoperative ileus were comparable between study groups (RR 0.47, 95% CI 0.17 to 1.29, P = 0.14, 3 RCTs, n = 279, I² = 0%, moderate-quality evidence). Early commencement of oral fluids and food was not associated with increased nausea or vomiting (RR 1.03, 95% CI 0.64 to 1.67; 4 RCTs, N = 484, I² = 73%, moderate-quality evidence). Early feeding was associated with shorter time to the presence of bowel sound (MD -0.32 days, 95% CI -0.61 to -0.03, P = 0.03, 2 RCTs, n = 338, I² = 52%, moderate-quality evidence) and faster onset of flatus(MD -0.21 days, 95% CI -0.40 to -0.01, P = 0.04, 3 RCTs, n = 444, I² = 23%, moderate-quality evidence), shorter time to first solid diet (MD -1.47 days, 95% CI -2.26 to -0.68; 2 RCTs, n = 301, I² = 92%, moderate-quality evidence), and a shorter hospital stay (MD -0.92 days, 95% CI -1.53 to -0.31; 4 RCTs, n = 484, I² = 68%, moderate-quality evidence). Infectious complications were less common in the early feeding group (RR 0.20, 95% CI 0.05 to 0.73; 2 RCTs, n = 183, I² = 0%, high-quality evidence).
Comment: The quality of evidence is downgrade by inconsistency (heterogeneity in interventions and outcomes) and by imprecise results (limited study size for each comparison).
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