title: Feasibility and outcomes of early oral feeding after total gastrectomy for cancer.
abstract: BACKGROUND
  Little data are available supporting the feasibility and safety of early oral feeding in patients after total gastrectomy. The aim of this study was to analyze the potential applicability of early provision of oral diet in these settings.
  
  
  METHODS
  Medical records of 353 patients who underwent total gastrectomy for gastric cancer between 2006 and 2012 were retrospectively analyzed. Early oral feeding was defined as clear liquid diet on postoperative day (POD) 1 followed by gradual introduction of solid diet on POD 2 to 3. Late oral feeding was defined as initiation of liquid diet from POD 4 to 6 and gradually advancing to solid diets.
  
  
  RESULTS
  Early oral feeding was implemented in 185 of 353 (52 %) patients. Prompt provision of food did not increase the risk of anastomotic failure (odds ratio 0.924, 95 % confidence interval 0.609-1.402, P = 0.709). The number of reoperations and in-hospital mortality rates was unaffected by the timing of nutritional intervention. Early feeding tended to be associated with fewer surgical (15 vs 24 %, P = 0.027) and general (8 vs 23 %, P < 0.001) complications. However, subsequent multivariate regression models failed to confirm significant correlations between timing of oral meals and postoperative morbidity.
  
  
  CONCLUSIONS
  Our findings suggested that early oral feeding is feasible and safe after total gastrectomy for gastric cancer. However, benefits of such early nutritional interventions require further studies.
authors.affiliation: First Department of Surgery, Jagiellonian University Medical College, 40 Kopernika Street, 31-501, Krakow, Poland, marek.sierzega@uj.edu.pl.
authors.forename: Marek
authors.initials: M
authors.lastname: Sierzega
authors.forename: Ryszard
authors.initials: R
authors.lastname: Choruz
authors.forename: Szymon
authors.initials: S
authors.lastname: Pietruszka
authors.forename: Piotr
authors.initials: P
authors.lastname: Kulig
authors.forename: Piotr
authors.initials: P
authors.lastname: Kolodziejczyk
authors.forename: Jan
authors.initials: J
authors.lastname: Kulig
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000209:etiology; D001628:Beverages / Q000009:adverse effects; D004750:Enteral Nutrition / Q000009:adverse effects; D005240:Feasibility Studies; D005260:Female; D005502:Food / Q000009:adverse effects; D005743:Gastrectomy / Q000009:adverse effects*; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011184:Postoperative Period; D012086:Reoperation; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors