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

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ji Chen ◽  
Ming Xu ◽  
Yunpeng Zhang ◽  
Chun Gao ◽  
Peng Sun
Keyword(s):  
Gastric Cancer ◽  
Hospital Stay ◽  
Gastric Surgery ◽  
Postoperative Hospital Stay ◽  
Oral Feeding ◽  
Chinese Patients ◽  
Patient Specific ◽  
Feeding Schedule ◽  
Early Oral Feeding ◽  
Eras Protocol

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.

scholarly journals Early oral feeding is safe and useful after rectosigmoid resection with anastomosis during cytoreductive surgery for primary ovarian cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kazuyoshi Kato ◽  
Kohei Omatsu ◽  
Sanshiro Okamoto ◽  
Maki Matoda ◽  
Hidetaka Nomura ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Cytoreductive Surgery ◽  
Group Versus ◽  
Postoperative Hospital Stay ◽  
Oral Feeding ◽  
Early Oral Feeding ◽  
Rectosigmoid Resection ◽  
Primary Ovarian Cancer

Abstract Background The aim of this study was to investigate the safety and clinical usefulness of early oral feeding (EOF) after rectosigmoid resection with anastomosis for the treatment of primary ovarian cancer. Methods We performed a retrospective review of all consecutive patients who had undergone rectosigmoid resection with anastomosis for primary ovarian, tubal, or peritoneal cancer between April 2012 and March 2019 in a single institution. Patient-related, disease-related, and surgery-related data including the incidence of anastomotic leakage and postoperative hospital stay were collected. EOF was introduced as a postoperative oral feeding protocol in September 2016. Before the introduction of EOF, conventional oral feeding (COF) had been used. Results Two hundred and one patients who underwent rectosigmoid resection with anastomosis, comprised of 95 patients in the COF group and 106 patients in the EOF group, were included in this study. The median number of postoperative days until the start of diet intake was 5 (range 2–8) in the COF group and 2 (range 2–8) in the EOF group (P < 0.001). Postoperative morbidity was equivalent between the groups. The incidence of anastomotic leakage was similar (1%) in both groups. The median length of the postoperative hospital stay was reduced by 6 days for the EOF group: 17 (range 9–67) days for the COF group versus 11 (8–49) days for the EOF group (P < 0.001). Conclusion EOF provides a significant reduction in the length of the postoperative hospital stay without an increased complication risk after rectosigmoid resection with anastomosis as a part of cytoreductive surgery for primary ovarian cancer.

scholarly journals Early oral Feeding is Safe and Useful after Rectosigmoid Resection with Anastomosis During Cytoreductive Surgery for Primary Ovarian Cancer

2020 ◽  
Author(s):  
Kazuyoshi Kato ◽  
Kohei Omatsu ◽  
Sanshiro Okamoto ◽  
Maki Matoda ◽  
Hidetaka Nomura ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Hospital Stay ◽  
Anastomotic Leakage ◽  
Cytoreductive Surgery ◽  
Group Versus ◽  
Postoperative Hospital Stay ◽  
Oral Feeding ◽  
Early Oral Feeding ◽  
Rectosigmoid Resection ◽  
Primary Ovarian Cancer

Abstract BackgroundThe aim of this study was to investigate the safety and clinical usefulness of early oral feeding (EOF) after rectosigmoid resection with anastomosis for the treatment of primary ovarian cancer.MethodsWe performed a retrospective review of all consecutive patients who had undergone rectosigmoid resection with anastomosis for primary ovarian, tubal, or peritoneal cancer during a 7-year period. Patient-related, disease-related, and surgery-related data including the incidence of anastomotic leakage and postoperative hospital stay were collected. EOF was introduced as a postoperative oral feeding protocol during the middle of the study period. Before the introduction of EOF, conventional oral feeding (COF) had been used.ResultsTwo hundred and one patients who underwent rectosigmoid resection with anastomosis, comprised of 95 patients in the COF group and 106 patients in the EOF group, were included in this study. The median number of postoperative days until the start of diet intake was 5 (range: 2–8) in the COF group and 2 (range: 2–8) in the EOF group (P < 0.001). Postoperative morbidity was equivalent between the groups. The incidence of anastomotic leakage was similar (1%) in both groups. The median length of the postoperative hospital stay was reduced by 6 days for the EOF group: 17 (range: 9–67) days for the COF group versus 11 (8–49) days for the EOF group (P < 0.001).ConclusionEOF provides a significant reduction in the length of the postoperative hospital stay without an increased complication risk after rectosigmoid resection with anastomosis as a part of cytoreductive surgery for primary ovarian cancer.

scholarly journals Our experience with laparoscopic total gastrectomy for gastric cancer: A case series

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Manash Ranjan Sahoo ◽  
Satyajit Samal ◽  
Jyotirmay Nayak
Keyword(s):  
Gastric Cancer ◽  
Blood Loss ◽  
Hospital Stay ◽  
Total Gastrectomy ◽  
Median Time ◽  
Operative Time ◽  
Laparoscopic Total Gastrectomy ◽  
Oral Feeding ◽  
Care Hospital ◽  
Intraoperative Blood Loss

Background: Though laparoscopic distal gastrectomy has become a standard procedure for treatment of gastric cancer, laparoscopic total gastrectomy has not been widely accepted as it requires more dexterity and lack of evidence about its feasibility and safety. Methods: Here retrospectively we review a series of 12 cases of gastric cancer undergone laparoscopic total gastrectomy with D1 or D2 lymphadenectomy over a period of 7 years at a tertiary care hospital. The patient demographic characteristics were reviewed and the outcomes after surgery was analyzed in terms of extent of lymphadenectomy, mean operative time, mean intraoperative blood loss median number of lymph nodes harvested, median time for postoperative ambulation, median time for postoperative oral feeding, median time of postoperative hospital stay, postoperative complications and mortality. Results: All patients had total gastrectomy entirely through laparoscopic method. Mean operative time was 282 minutes, mean intraoperative blood loss was 120 ml, median time for ambulation and oral feeding was 3 days and 6 days respectively. Median time of hospital stay was 16 days and 2 patients had complications as pancreatic fistula and port site abscess. No mortality was observed. Conclusion: With zero mortality and accepted rate of complications, laparoscopic total gastrectomy appears to be technically feasible and safe for management of gastric cancer. But more studies have to be conducted with comparison to other standard gastrectomies and long term follow up to be done to establish its standardized application.

Effect of early oral feeding after gastric cancer surgery: A result of randomized clinical trial

Surgery ◽  
2011 ◽  
Vol 149 (4) ◽  
pp. 561-568 ◽  
Author(s):  
Hoon Hur ◽  
Sung Geun Kim ◽  
Jung Ho Shim ◽  
Kyo Young Song ◽  
Wook Kim ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Cancer Surgery ◽  
Oral Feeding ◽  
Gastric Cancer Surgery ◽  
Early Oral Feeding

scholarly journals Enhanced Recovery After Colorectal Surgery (ERAS) in Elderly Patients Is Feasible and Achieves Similar Results as in Younger Patients

2017 ◽  
Vol 3 ◽  
pp. 233372141770629 ◽  
Author(s):  
Håvard Mjørud Forsmo ◽  
Christian Erichsen ◽  
Anne Rasdal ◽  
Hartwig Körner ◽  
Frank Pfeffer
Keyword(s):  
Colorectal Surgery ◽  
Elderly Patients ◽  
Hospital Stay ◽  
Enhanced Recovery ◽  
Patient Adherence ◽  
Controlled Trial ◽  
Age Groups ◽  
Postoperative Hospital Stay ◽  
Younger Patients ◽  
Eras Protocol

Aim: Enhanced recovery after surgery (ERAS) is a multimodal approach that aims to optimize perioperative treatment. Whether elderly patients receiving colorectal surgery can adhere to and benefit from an ERAS approach is uncertain. The aim of this study was to compare patients in different age groups participating in an ERAS program. Method: In this substudy of a randomized controlled trial, we analyzed the interventional ERAS arm of adult patients eligible for laparoscopic or open colorectal resection with regard to the importance of age. Patients were divided into three groups based on age: ≤65 years ( n = 79), 66-79 years ( n = 56), and ≥80 years ( n = 19). The primary end point was total postoperative hospital stay (THS). Secondary end points were postoperative hospital stay, postoperative complications, postoperative C-reactive protein levels, readmission rate, mortality, and patient adherence to the different ERAS elements. All parameters and measuring the adherence to the ERAS protocol were recorded before surgery, on the day of the operation, and daily until discharge. Results: There were no significant differences in length of THS between age groups (≤65 years, median 5 [range 2-47] days; 66-79 years, median 5.5 [range 2-36] days; ≥80 years, median 7 [range 3-50] days; p = .53). All secondary outcomes were similar between age groups. Patient adherence to the ERAS protocol was as good in the elderly as it was in the younger patients. Conclusion: Elderly patients adhered to and benefited from an ERAS program, similar to their younger counterparts.

Impact of double-flap technique for reconstruction after proximal gastrectomy.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 134-134
Author(s):  
Kazuki Asanuma ◽  
Hirofumi Kawakubo ◽  
Shuhei Mayanagi ◽  
Rieko Nakamura ◽  
Tomoyuki Irino ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastroesophageal Reflux ◽  
Hospital Stay ◽  
Proximal Gastrectomy ◽  
Operation Time ◽  
Postoperative Hospital Stay ◽  
Endoscopic Findings ◽  
Flap Technique ◽  
Postoperative Reflux ◽  
One Year

134 Background: Proximal gastrectomy (PG) has been performed for proximal early gastric cancer as a minimally invasive procedure. In PG, gastroesophageal reflux disease (GERD) becomes problem, thus several techniques have been reported to reduce GERD. So far, we have mainly performed the method of anastomosis based on double stapling technique (DST) using a trans-oral anvil delivery system for reconstruction after PG. For preventing GERD, we recently introduced double-flap technique (DFT) reported to be more physiological anti-reflux reconstruction which can prevent GERD. So, this study shows superiority of DFT compared to DST. Methods: Patients who have undergone PG for proximal gastric cancer during Jan. 2012 to Jul. 2017 in our hospital were reviewed as candidates. Operation time, blood loss, postoperative anastomotic complication, postoperative hospital stay, postoperative reflux symptom or endoscopic findings, intake of proton pump inhibitor (PPI) at 1 year after the operation, and postoperative nutritional status were retrospectively investigated. Results: DFT was performed in 26 patients whereas DST was performed in 38 patients. Average operation time and postoperative hospital stay was not significant in both groups (DFT group; 275.8±41.4 minutes, 13.6±8.9 days, DST group; 252.2±82.9 minutes, 15.2±7.2 days, respectively). As for postoperative complications higher than Clavien-Dindo Grade III, one case of suture failure was observed in DFT group. Postoperative reflux symptoms and endoscopic findings of gastroesophageal reflux were significantly frequent in DST group compared to DFT group (Reflux symptoms, DFT group : DST group = 0 : 7(p = 0.03), Endoscopic findings, DFT group : DST group = 1 : 11(p < 0.01) , respectively). There were significantly more cases of PPI taking one year after the operation in DST group(DFT group : DST group = 8 : 28 (p < 0.01) ). Average weight loss at one year after the operation and serum level of albumin of in DFT group were 6.0±4.7kg and 4.11±0.29 g/dL, respectively and DST group were 7.6±5.3kg and 3.95±0.39 g/dL, respectively and there were no significance between two groups. Conclusions: DFT is superior to DST as a reconstruction method after PG in terms of suppressing GERD.

scholarly journals Fast Track Recovery Surgery with A Whey Protein Infused Carbohydrate Loading Drink Pre-Operatively and Early Oral Feeding Post-Operatively among Surgical Gynaecologic Cancer Patients: Study Protocol of an Open Labelled Randomised Controlled Trial

2019 ◽  
Author(s):  
Chiou Yi Ho ◽  
Zuriati Ibrahim ◽  
Zalina Abu Zaid ◽  
Zulfitri 'Azuan Mat Daud ◽  
Nor Baizura Md Yu
Keyword(s):  
Hospital Stay ◽  
Cancer Patients ◽  
Whey Protein ◽  
Intervention Group ◽  
Oral Feeding ◽  
Control Group ◽  
Bowel Sound ◽  
Early Oral Feeding ◽  
Carbohydrate Loading ◽  
Gynaecologic Cancer

Abstract Introduction: There has been growing evidence on the favourable outcomes of fast tract recovery (FTR) surgery; expedite recovery, minimise complications, reduce length of hospital stay on surgical patients. However, there is lack of evidence on the effectiveness of FTR in surgical gynaecologic cancer patients. Most of previous study did not focus on feeding composition in FTR surgery protocol. This study aims to determine the effectiveness of FTR feeding with whey protein infused carbohydrate loading drink pre-operatively and early oral feeding post-operatively on post-operative outcomes among surgical gynaecologic cancer patients. Methods and analysis: This open labelled RCT will randomly allocate patients into intervention and control group. Ambulated Malaysian aged over 18 years and scheduled for elective surgery for (suspected) GC, will be included in this study. Intervention group will be given whey protein infused carbohydrate loading drinks evening before operation and 3 hours before operation as well as started on early oral feeding 4 hours post-operatively. Control group will be fasted overnight pre-operation and only allowed plain water, and the diet transition fashion is followed when there is bowel sound post-operatively. Primary outcomes of study are length of post-operative hospital stay, length of clear fluid toleration, solid food toleration and bowel function. Additional outcome measures are changes in nutritional status, biochemical profile and functional status. Data will be analysed on an intention-to-treat basis. Trial Registration Number: ClinicalTrials.gov, NCT03667755. Registered 12 September 2018 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03667755

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