Fast-track Surgery Improves Postoperative Recovery in Patients with Gastric Cancer: A Randomized Comparison with Conventional Postoperative Care

Wang, Dongsheng; Kong, Ying; Zhong, Bei; Zhou, Xiaobin; Zhou, Yanbing

doi:10.1007/s11605-009-1139-5

Cited by 153 publications

(210 citation statements)

References 38 publications

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“…In their study, no differences were found with respect to postoperative morbidity and mortality, but the recovery of bowel function was significantly improved in the early diet group. In addition, in one study about ''fast-track surgery'' in patients with gastric cancer, Wang et al [28] introduced oral nutrition on the first postoperative day and found that hospital stays and medical costs were reduced and quality of life was improved. Unlike the study by Wang et al, the present study more specifically focused on the early oral feeding after gastrectomy.…”

Section: Discussionmentioning

confidence: 99%

The safety and feasibility of early postoperative oral nutrition on the first postoperative day after gastrectomy for gastric carcinoma

et al. 2013

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Background Unlike the wide acceptance of early enteral nutrition after colorectal surgery, little information is available regarding the feasibility of immediate oral nutrition after gastric cancer surgery. This study evaluated the feasibility and safety of oral nutrition on the first postoperative day after gastrectomy. Methods From September 2010 to March 2011, 74 consecutive gastric cancer patients received an oral diet on the first postoperative day after gastrectomy. Surgical outcomes, including hospital stay, morbidity, and mortality, were compared with a conventional diet group (n = 96, before September 2010), in which an oral diet was started on the third or fourth postoperative day.Results No significant differences were found in the clinicopathological characteristics or operation types between the two groups. Average diet start times in the early diet (ED) and conventional diet (CD) groups were 1.8 and. 3.2, respectively (p \ 0.001). The mean hospital stay was significantly shorter in the ED group (7.4 vs. 8.9 days, p = 0.004). There was no significant difference in postoperative morbidity (p = 0.947) between the two groups. Gastrointestinal-related complications, such as anastomosis leakage or postoperative ileus, were also similar in the two groups. Overall compliance to early oral nutrition in the ED group was 78.5 %, and an old age (C70 years) was found to affect the compliance to early postoperative oral nutrition. Conclusions Postoperative oral nutrition is safe and feasible on the first postoperative day after gastrectomy. However, elderly patients require careful monitoring when applying early oral nutrition after gastrectomy.

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Section: Discussionmentioning

confidence: 99%

The safety and feasibility of early postoperative oral nutrition on the first postoperative day after gastrectomy for gastric carcinoma

et al. 2013

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“…Wang et al [15] reported that the first day of flatus after gastric surgery was earlier in patients who received fast-track surgery care than in those who received conventional care (3 vs. 4 days). Teeuwen et al [5] found that oral intake in their ERAS group was higher than that in the conventional group after colorectal surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Because laboratory testing was performed on POD 7 in both groups, the mean day of discharge did not differ significantly. Wang et al [15] reported that the postoperative hospital stay after gastric surgery was shorter in patients who received fast-track surgery care than in those who received conventional care.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of enhanced recovery after surgery protocol as compared with conventional perioperative care in gastric surgery

et al. 2011

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Background Radical gastrectomy for gastric cancer is among the most invasive procedures in gastrointestinal surgery. Several studies have found that an enhanced recovery after surgery (ERAS) protocol is useful in patients who undergo colorectal surgery, but its value in gastric surgery remains uncertain. The aim of this study was to assess the usefulness of an ERAS protocol for gastric surgery. Methods We studied the clinical characteristics, oncological factors, surgical factors, and outcomes in patients who underwent elective radical gastrectomy for gastric cancer before and after the introduction of an ERAS protocol.Results The first days of oral intake, oral intake recovery, flatus, and defecation were significantly earlier in the ERAS group (n = 91) than in the conventional care (CONV) group (n = 100). Maximum pain evaluated on a visual analog scale and the number of additional analgesics on demand were significantly less in the ERAS group than in the CONV group. The ratio of the postoperative body weight at 1 week to the preoperative body weight was significantly higher in the ERAS group than in the CONV group (0.95 vs. 0.94, respectively, P = 0.01). Conclusion Our results suggest that the ERAS protocol is useful in patients who undergo elective radical gastrectomy.

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“…A randomized comparison between fast-track surgery and conventional care in gastric cancer patients (n = 45 and n = 47 respectively) showed less stress response in the fast-track surgery group [105] . This was measured by serum tumor necrosis factor-alfa, CRP and interleukin-6 levels.…”

Section: Advances In Postoperative Carementioning

confidence: 98%

Improving the outcomes in gastric cancer surgery

Tegels¹,

Maat²,

Hulsewé³

et al. 2014

WJG

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Fast-track Surgery Improves Postoperative Recovery in Patients with Gastric Cancer: A Randomized Comparison with Conventional Postoperative Care

Abstract: Fast-track surgery can lessen postoperative stress reactions and accelerate rehabilitation for patients with gastric cancer.

Cited by 153 publications

References 38 publications

The safety and feasibility of early postoperative oral nutrition on the first postoperative day after gastrectomy for gastric carcinoma

The safety and feasibility of early postoperative oral nutrition on the first postoperative day after gastrectomy for gastric carcinoma

Usefulness of enhanced recovery after surgery protocol as compared with conventional perioperative care in gastric surgery

Improving the outcomes in gastric cancer surgery

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