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The aim of this study is to determine whether early oral feeding after curative resection for gastric cancer would be tolerable and give an effect on the recovery.
Most patients who undergo gastric resection for gastric cancer have maintained going on a fast of over three days after operation. Surgeons have believed that early oral feeding might worsen patients' condition by prolonged postoperative ileus. Therefore, patients received nothing by oral route until resolution of the ileus. However, the current trend toward minimal operative injury and early discharge from hospital. In addition, development of operative technique and instrument make the operation time to be short and the patients to be fast recovery, and thus it is possible to feed early in less than two days after operation. The aim of this study is to determine whether early oral feeding after curative resection for gastric cancer would be tolerable and give an effect on the recovery.
We collect fifty-eight patients for this study and divide into two groups using randomization method. In the early feeding group, patients will receive the liquid diet two day after operation followed by soft diet postoperative three day. Meanwhile, the patients who categorized into control group will start the liquid diet postoperative four day followed by soft diet postoperative six day. We evaluate the morbidity or mortality rate and laboratory findings. Of course, it is supposed to be same in amount of fluid and calories between two groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 1 | No Intervention | Conventional feeding : They begin ingesting sips of water on third postoperative day and continued with a liquid diet for the next two days. Patients were given a soft diet on sixth postoperative day. |
|
| 2 | Experimental | Early oral feeding : The patients begin ingesting sips of water on the first postoperative day. If they are tolerable, they continued with a clear liquid diet the next day and a soft diet on the third post operative day. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conventional feeding | Other | Procedure of Conventional feeding group: Patients are supplied water on day 3 after operation, liquid diet on day 4 and 5 and soft diet on 6 day. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Days of hospital stay after operation | We measure the length of hospital stay after operation | within 30 days after operation |
| Measure | Description | Time Frame |
|---|---|---|
| Day of recovery of bowel sound and flatus: Evidence of recovery of bowel sound by physician's examination and Evidence of first flatus by question to patient | We measure the days of flatus within 30 days after operation | within 30 days after operation |
| Laboratory findings after operation: Albumin, complete blood count, total cholesterol, cholinesterase and C-reactive protein are measured |
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Inclusion Criteria:
Patients who underwent gastrectomy for adenocarcinoma of stomach with following criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Hae Myung Jeon, MD | Department of Surgery, St Mary's Hospital, The Catholic University of Korea | Principal Investigator |
| Hoon Hur, MD | Department of Surgery, St Mary's Hospital, The Catholic University of Korea | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| St Mary's Hospital, The Catholic University of Korea | Seoul | 150-713 | South Korea |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 15532842 | Background | Suehiro T, Matsumata T, Shikada Y, Sugimachi K. Accelerated rehabilitation with early postoperative oral feeding following gastrectomy. Hepatogastroenterology. 2004 Nov-Dec;51(60):1852-5. | |
| 15946413 | Background | Gabor S, Renner H, Matzi V, Ratzenhofer B, Lindenmann J, Sankin O, Pinter H, Maier A, Smolle J, Smolle-Juttner FM. Early enteral feeding compared with parenteral nutrition after oesophageal or oesophagogastric resection and reconstruction. Br J Nutr. 2005 Apr;93(4):509-13. doi: 10.1079/bjn20041383. |
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| ID | Term |
|---|---|
| D013274 | Stomach Neoplasms |
| ID | Term |
|---|---|
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| Early oral feeding | Other | Procedure of Early oral feeding group: Patients are supplied water on day 1 after operation, liquid diet on day 2 and soft diet on day 3 day. |
|
| 1,3,5 and 7 day after operation |
| Symptom of Patients: Question to patients about symptoms | before operation and 1,3,5,7 day after operation |
| Cost effectiveness: Total cost duration of hospitalization | We measure total cost from admission to discharge after operation | within 30 days after admission |
| Quality of life: EORTC QLQ30, STO22 | 1,2 and 3 month after operation |
| Immunologic Outcomes : IL-1, IL-2, IL-6, IL-8, TNF-a will by measured by ELISA | before operation and 1,3,5,7 day after operation |
| Postoperative morbidity rate in hospital days: Clinically definite morbidity confirmed by physicians according to offered protocol | We observe the occurrence of morbidity after operation | within 30 days after operation |
| 7618972 | Background | Reissman P, Teoh TA, Cohen SM, Weiss EG, Nogueras JJ, Wexner SD. Is early oral feeding safe after elective colorectal surgery? A prospective randomized trial. Ann Surg. 1995 Jul;222(1):73-7. doi: 10.1097/00000658-199507000-00012. |
| 19399550 | Derived | Hur H, Si Y, Kang WK, Kim W, Jeon HM. Effects of early oral feeding on surgical outcomes and recovery after curative surgery for gastric cancer: pilot study results. World J Surg. 2009 Jul;33(7):1454-8. doi: 10.1007/s00268-009-0009-3. |
| D004066 |
| Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D013272 | Stomach Diseases |