title: Feasibility study of early oral intake after gastrectomy for gastric carcinoma.
abstract: OBJECTIVE
  Despite the compelling scientific and clinical data supporting the use of early oral nutrition after major gastrointestinal surgery, traditional bowel rest and intravenous nutrition for several postoperative days is still being used widely after gastric cancer surgery.
  
  
  METHODS
  A phase II study was carried out to evaluate the feasibility and safety of postoperative early oral intake (water intake on postoperative days (POD) 1-2, and soft diet on POD 3) after a gastrectomy. The primary outcome was morbidity within 30 postoperative days, which was targeted at <25% based on pilot study data.
  
  
  RESULTS
  The study subjects were 90 males and 42 females with a mean age 61.5 years. One hundred and four (79%) and 28 (21%) patients underwent a distal and total gastrectomy, respectively. The postoperative morbidity rate was within the targeted range (15.2%, 95% CI, 10.0~22.3%), and there was no hospital mortality. Of the 132 patients, 117 (89%) successfully completed a postoperative early oral intake regimen without deviation; deviation in 10 (8%) due to gastrointestinal symptoms and in five (4%) due to the management of postoperative complications. The mean times to water intake and a soft diet were 1.0±0.2 and 3.2±0.7 days, respectively, and the mean hospital stay was 10.0±6.1 days.
  
  
  CONCLUSIONS
  Postoperative early oral intake after a gastrectomy is feasible and safe, and can be adopted as a standard perioperative care after a gastrectomy. Nevertheless, further clinical trials will be needed to evaluate the benefits of early oral nutrition after upper gastrointestinal surgery.
authors.affiliation: Division of Gastroenterologic Surgery, Department of Surgery, Chonnam National University Hwasun Hospital, Hwasun, Korea.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Jo
authors.forename: Oh
authors.initials: O
authors.lastname: Jeong
authors.forename: Jang Won
authors.initials: JW
authors.lastname: Sun
authors.forename: Mi Ran
authors.initials: MR
authors.lastname: Jeong
authors.forename: Seong Yeop
authors.initials: SY
authors.lastname: Ryu
authors.forename: Young Kyu
authors.initials: YK
authors.lastname: Park
references.citation: Langenbecks Arch Surg. 2003 Feb;387(11-12):441-9
references.pmid: 12607126
references.citation: Aust N Z J Surg. 1996 Oct;66(10):668-70
references.pmid: 8855920
references.citation: Br J Surg. 2004 Sep;91(9):1138-45
references.pmid: 15449264
references.citation: Anesth Analg. 2001 Jun;92(6):1594-600
references.pmid: 11375853
references.citation: JPEN J Parenter Enteral Nutr. 1981 May-Jun;5(3):215-20
references.pmid: 6788969
references.citation: J Am Coll Surg. 1995 Jul;181(1):26-32
references.pmid: 7599767
references.citation: Am J Surg. 1997 Sep;174(3):325-30
references.pmid: 9324147
references.citation: Ann Surg. 2008 Aug;248(2):189-98
references.pmid: 18650627
references.citation: Nutrition. 2002 Nov-Dec;18(11-12):944-8
references.pmid: 12431715
references.citation: World J Surg. 2009 Jul;33(7):1454-8
references.pmid: 19399550
references.citation: Hepatogastroenterology. 2004 Nov-Dec;51(60):1852-5
references.pmid: 15532842
references.citation: Eur J Surg. 2002;168(7):379-83
references.pmid: 12463426
references.citation: Ann Surg. 1997 Oct;226(4):567-77; discussion 577-80
references.pmid: 9351723
references.citation: Ann Surg. 2003 Nov;238(5):641-8
references.pmid: 14578723
references.citation: Ann Surg. 2008 May;247(5):721-9
references.pmid: 18438106
references.citation: N Engl J Med. 2008 Jul 31;359(5):453-62
references.pmid: 18669424
references.citation: JPEN J Parenter Enteral Nutr. 1991 Jul-Aug;15(4):376-83
references.pmid: 1910100
references.citation: Am J Obstet Gynecol. 2002 May;186(5):861-5
references.pmid: 12015496
references.citation: Lancet. 2002 May 25;359(9320):1812-8
references.pmid: 12044376
references.citation: Dig Surg. 2005;22(5):346-52; discussion 352
references.pmid: 16293965
references.citation: Eur J Surg Oncol. 2004 Apr;30(3):303-8
references.pmid: 15028313
references.citation: World J Surg. 2005 Jul;29(7):853-7
references.pmid: 15951932
references.citation: Lancet. 1995 Mar 25;345(8952):763-4
references.pmid: 7891489
references.citation: Curr Opin Clin Nutr Metab Care. 2006 Sep;9(5):613-7
references.pmid: 16912559
references.citation: Vasc Endovascular Surg. 2003 Sep-Oct;37(5):329-34
references.pmid: 14528378
references.citation: BMJ. 2001 Oct 6;323(7316):773-6
references.pmid: 11588077
references.citation: Crit Care Med. 2001 Feb;29(2):242-8
references.pmid: 11246300
references.citation: Gastric Cancer. 1998 Dec;1(1):10-24
references.pmid: 11957040