Nutritional status of early oral feeding for gastric cancer patients after laparoscopic total gastrectomy: A retrospective cohort study.

Background: After Laparoscopic total gastrectomy (LTG), gastric cancer (GC) patients often face malnutrition. Early oral feeding (EOF) has emerged as a key strategy in enhanced recovery after surgery (ERAS) protocols. However, the impact of EOF on post-LTG nutritional status requires further investigation. This study aimed to compare the nutritional status of EOF, nasogastric tube (NGT) and nasojejunal tube (NJT) to figure out the status of EOF.

Methods: A retrospective comparative analysis of a single center (Second Hospital of Lanzhou University) of a total of 116 patients with LTG was performed. These included 40 NGT patients, 40 patients with NJT and 36 patients with EOF. Postoperative (7 days after surgery) nutritional status was examined as the primary endpoint, including weight, BMI, total protein, albumin, hemoglobin and total lymphocyte count (TLC). In addition, bowel sounds, abdominal distension and pain were evaluated as secondary endpoints.

Results: The collective shows no significant differences between the three groups regarding various demographic and clinical information (All, p > 0.05). There was no significant difference in the patients' nutritional status and bowel sound recovery 7 days after surgery (All, p > 0.05). The rate of abdominal distension shows to be significantly reduced with EOF compared to NJT (mean difference = 0.342; p < 0.001). The incidence of abdominal pain was significantly different between EOF and NGT groups (mean difference = 0.228; p < 0.001).

Conclusion: Among GC patients after LTG, EOF and traditional tube feeding had a similar risk of postoperative nutritional status. However, EOF was associated with a lower risk of abdominal distension.