Feasibility and Safety of Early Oral Feeding After Radical Gastrectomy in Patients With Gastric Carcinoma: A Systematic Review

TL;DR

This review evaluates whether starting oral feeding soon after stomach cancer surgery is safe and effective, finding it generally feasible with potential benefits.

Contribution

The study systematically reviews recent evidence on early oral feeding after radical gastrectomy, highlighting its feasibility and safety.

Findings

Early oral feeding is generally feasible and well-tolerated, with high adherence rates.

EOF may lead to shorter hospital stays and improved gastrointestinal recovery.

Complication rates were comparable or lower with EOF, though results were mixed.

Abstract

This systematic review examines the feasibility and safety of early oral feeding (EOF) after radical gastrectomy in patients with gastric cancer. A comprehensive literature search identified eight eligible studies, including both clinical trials and cohort studies, conducted between 2011 and 2020. The review analyzed outcomes such as postoperative complications, length of hospital stay, time to first flatus/bowel movement, and changes in nutritional markers. The findings suggest that EOF is generally feasible and well-tolerated, with high adherence rates reported across studies. Most patients successfully initiated oral intake within 72 hours post-surgery without significant protocol deviations. Regarding safety, the studies reported comparable or lower rates of postoperative complications in EOF groups compared to traditional feeding protocols, though some noted non-significant increases in complications with EOF. Several studies observed potential benefits of EOF, including shorter hospital stays, earlier return of gastrointestinal function, and improved nutritional status. However, the results were mixed, with some studies finding no significant differences in these outcomes. While the review suggests EOF is a viable option for postoperative management after radical gastrectomy, it emphasizes the importance of patient-specific factors and close monitoring during implementation. The heterogeneity in study designs, EOF protocols, and outcome measures limits direct comparisons. Future large-scale randomized controlled trials are warranted to establish standardized EOF protocols and provide more robust evidence for this patient population.

Figures