Early Oral Re-Feeding on Oncology Patients Submitted to Gastrectomy for Gastric Cancer

Abstract

Background: There is no advantage in maintaining patients on oral fasting after gastrointestinal elective resection. The early feeding up to 48 h can be beneficial, because it reduces infectious complications and hospital stay. Aim: Evaluate the evolution and tolerance of early oral diet in postoperative period after gastrectomy for gastric cancer. Methods: Anthropometric assessment was performed on the day of surgery, weight, height, body mass index and weight loss were measured. Acceptance of diet was evaluated as food intake (amount accepted) and gastrointestinal symptoms such as nausea, vomiting, constipation, diarrhea, abdominal distension, postoperative complications and hospital stay. Results: The sample consisted of 23 patients, 17 with partial gastrectomy and six with total gastrectomy. In the assessment of nutritional status 9% were malnourished, 54.5% normal weight, 9% overweight and 27.2% obese, but 54% had weight loss. There was good acceptance of the diet in 96,9% of the sample. Nausea and abdominal distension were present in 4,3% and 65.2% constipation. Surgical complications according to the Clavien scalle, 13% had grade V, 4.3% grade IIIA, 8.7% grade I and 73% did not have complications. The length of hospital stay was 5±2.2 days. Conclusion: Early postoperative re-feeding in total and partial gastrectomy was well tolerated by patients.

Perioperative fasting time among cancer patients submitted to gastrointestinal surgeries

“…It is known that changes in the nutritional condition compromise the functioning of the immune system, increasing the number of healthcare associated infections, the hospitalization period and healthcare costs and affecting negatively the healing (2) . The literature shows the improvement in postoperative recovery and patients' wellbeing related to the reduction of the fasting period by offering a preoperative solution rich in carbohydrates, two to three hours before the induction of anesthesia, shortened fasting length and an early oral nutrition during the postoperative period.…”

Jejum pré-operatório abreviado favorece realimentação pós-operatória com menor custo de internação hospitalar em pacientes oncológicos.

“…Table 2 shows the comparative results of postoperative outcomes and of the characteristics of the procedures performed for the groups in the study. The re-introduction of a complete postoperative food intake is a key factor for the immunophysiological recovery of the patients who underwent abdominal procedures 25,26 . The presence of intestinal transit assessed by peristaltic movement represents a predominant factor of the assessment of postoperative recovery in the majority of the surgical services, and allows for a safe diet progression 8,9,12,17 .…”

Changing Paradigms in Preoperative Fasting: Results of a Joint Effort in Pediatric Surgery

“…Although security is well established in preoperative abbreviation of fasting time 13 , 18 , 24 , we observe high strength from conventional services in pediatric surgery to implement this approach 7 . Likewise, studies show that early refeeding after operation is safe and optimizes postoperative recovery 10 .…”