PD1035 - THE SAFETY AND FEASIBILITY OF POSTOPERATIVE EARLY ORAL FEEDING AFTER TOTAL GASTRECTOMY FOR GASTRIC CANCER: MULTICENTER RANDOMIZED CONTROLLED TRIAL

PD1035

THE SAFETY AND FEASIBILITY OF POSTOPERATIVE EARLY ORAL FEEDING AFTER TOTAL GASTRECTOMY FOR GASTRIC CANCER: MULTICENTER RANDOMIZED CONTROLLED TRIAL

M.-R. Jung^1,*, O. Jeong¹, J. H. Kang¹, J.-H. Park², S. J. Lee³, C.-Y. Kim³, Y.-G. Son⁴, S. W. Ryu⁴, S. Y. Ryu⁵, O.-K. Kwon ⁶, K. B. Park⁶, J. Y. Park⁶

¹Surgery, Chonnam National University Medical School, Jeollanam-do, ²Surgery, Gyeongsang National University Hospital, Jinju, ³Surgery, Jeonbuk National University Medical School, Jeonju, ⁴Surgery, Keimyung University School of Medicine, Daegu, ⁵Surgery, Chosun University College of Medicine, Gwangju, ⁶Surgery, Kyungpook National University Chilgok Hospital, Daegu, Korea, Republic Of

Rationale: Early oral feeding (EOF) is a key component of Enhanced Recovery After Surgery (ERAS) protocols. However, evidence supporting EOF after total gastrectomy (TG) remains limited.

Methods: This was a multicenter, prospective, randomized controlled trial. Patients with gastric cancer indicated for TG were randomly assigned to either EOF group or conventional feeding group. In EOF group, a solid diet was initiated at lunch on postoperative day (POD) 1, whereas in conventional group, a solid diet was started on POD 3. The primary endpoint was the rate of postoperative complications within 30 days. Secondary endpoints included anastomosis-related complications, length of hospital stay, postoperative functional recovery time, non-compliance with oral feeding, and nutritional markers.

Results: A total of 119 patients were enrolled between March 2020 and January 2024 (EOF group, n=57; conventional group, n=62). There was no significant difference in overall postoperative complication rates between two groups (14.0% vs. 14.5%, p=0.940). Anastomosis-related complications, including leakage (1.8% vs. 3.2%, p=1.000) and luminal bleeding (0% vs. 1.6%, p=1.000), as well as aspiration pneumonia (1.8% vs. 1.7%, p=1.000), were comparable between groups. Non-compliance with oral feeding was low in both groups (5.3% vs. 6.5%). The EOF group demonstrated a significantly shorter time to first flatus (2.6 vs. 3.0 days, p=0.031). Although the EOF group showed trends toward shorter hospital stay and faster functional recovery, these differences were not statistically significant. Nutritional parameters measured on POD 5 and POD 30 were comparable between two groups.

Conclusion: EOF after TG for gastric cancer is safe and feasible. When incorporated with other ERAS components, EOF may contribute to enhanced postoperative recovery.

Disclosure of Interest: None declared