Effects of a stepwise, local patient-specific early oral feeding schedule after gastric cancer surgery: a single-center retrospective study from China

Ji Chen,Chun Gao,Yunpeng Zhang,Ming Xu,Peng Sun

doi:10.1038/s41598-019-52629-0

Ji Chen, Chun Gao + Show 3 more

Open Access

https://doi.org/10.1038/s41598-019-52629-0

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Journal: Scientific Reports	Publication Date: Nov 12, 2019
Citations: 6	License type: open-access

Affiliation: Tongren Hospital, Shanghai Jiao Tong University

Abstract

Nowadays, early oral feeding after gastrectomy has been gradually accepted and applied in the clinical practice, but there is still no specific uniform feeding regimen available which works best for patients in different regions with different races and eating habits. Aiming to establish an early oral feeding schedule suitable for local Chinese patients after gastric surgery, from May 2014 to May 2018, 87 gastric cancer patients undergoing various types of gastric resections were enrolled in an early feeding protocol and their clinical course was reviewed retrospectively. A stepwise, local patient-specific, early oral feeding schedule was proposed, implemented within an early recovery after surgery (ERAS) protocol and accessed in terms of its safety and tolerability. The primary surgical outcomes included: a median (interquartile range; IQR) postoperative hospital stay of 6 (3) days; 67 (77%) patients were well tolerant of this schedule from postoperative day (POD) 1 to POD 4; 20 (23%) patients had mild I/II grade complications (Clavien-Dindo classification); 3 (3%) patients had IIIB complications, zero cases of hospital mortality. Compared to similar studies in the past, our early oral feeding program is also safe and beneficial, and it can shorten the postoperative hospital stay without causing any increase in postoperative complications. In summary, our work herein reported the establishment of a detailed early oral feeding schedule embedded within an ERAS protocol which was found to be suitable for local Chinese patients after gastric surgery. Accordingly, this early oral feeding schedule is worth further research and promotion.

Highlights

Nowadays, early oral feeding after gastrectomy has been gradually accepted and applied in the clinical practice, but there is still no specific uniform feeding regimen available which works best for patients in different regions with different races and eating habits
In order to avoid postoperative complications of anastomotic leakage and postoperative paralytic ileus, the traditional idea is that feeding should not be started for patients after gastric resection until flatus or defecation has documented the return of bowel function[5,6]
There is no comparison done between the early oral feeding group and a control group in our study, the duration of postoperative stay was shortened compared to the results from the above-mentioned two studies and other studies as well[21,37,38]. All of these results indicate that patients who underwent gastrectomy had shorter postoperative hospital stays without increasing postoperative complications[11]

Summary

Introduction

Early oral feeding after gastrectomy has been gradually accepted and applied in the clinical practice, but there is still no specific uniform feeding regimen available which works best for patients in different regions with different races and eating habits. Aiming to establish an early oral feeding schedule suitable for local Chinese patients after gastric surgery, from May 2014 to May 2018, 87 gastric cancer patients undergoing various types of gastric resections were enrolled in an early feeding protocol and their clinical course was reviewed retrospectively. A stepwise, local patient-specific, early oral feeding schedule was proposed, implemented within an early recovery after surgery (ERAS) protocol and accessed in terms of its safety and tolerability. Our work reported the establishment of a detailed early oral feeding schedule embedded within an ERAS protocol which was found to be suitable for local Chinese patients after gastric surgery. This early oral feeding schedule is worth further research and promotion. Time 7:00 am 9:30 am 11:30 am 14:30 pm 17:00 pm 20:00 pm Components (Calories) 100 ml of 25% Maltodextrin (50 kcal) 15 g of Lotus root starch and 15 g of albumen powder in 50 ml (109 kcal) g of Ensure or g of Glucema in 100 ml (100 kcal) Rice-water plus 15 g of albumen powder in 50 ml g of Ensure or g of Glucema in 100 ml (100 Kcal) 25 g of Whey protein powder in 100 ml (100 kcal)

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