Safety and benefits of early oral nutrition as part of the fast-track program among patients who have undergone gastrectomy for stomach cancer

Abstract

Over the past decade, stomach cancer continues to be one of the most common diseases in the world. Currently, the methods of conservative and surgical treatment of this disease are fairly standardized. However, the issue of postoperative management of patients, including the timing of the start of oral nutrition after surgery still remains debatable. In addition, modern methods of treatment are based on the use of protocols for enhanced recovery after surgery, the safety of which remains controversial and requires discussion.Study object was to explore the safety and benefits of early oral nutrition among patients who have undergone gastrectomy for stomach cancer.Material and methods. The authors present their own experience of nutritional support for patients who underwent gastrectomy. The study included 82 patients with locally advanced stomach cancer who received surgical treatment at the n.i. Pirogov clinic of high medical technologies in the period from 2016 to 2019.Results. The safety and positive effect of the use of early oral feeding was proved. It was associated with shorter first exhaust time (2.8 ± 1.0 days vs 3.9 ± 1.2 days, p=0.001), shorter postoperative length of stay in the hospital (5.4 ± 1.5 days vs 9.5 ± 2.3 days; p=0.001), as well as a more dynamic recovery of laboratory parameters.Conclusion. Early per oral nutrition after gastrectomy can reduce the length of hospital stay without increasing the incidence of concomitant complications, which indicates its safety, expediency and potential benefit for patients with gastric cancer.

Keywords

• gastric cancer
• gastrectomy
• nutritional support
• early oral nutrition
• enteral nutrition
• fast-track surgery
• perioperative care