Evaluation of early liquid drinking after radical gastrectomy in gastric cancer: a Chinese multicenter propensity score matching analysis

Author:

Zhang Yue12,Tao Kaixiong3,Yu Jinlong4ORCID,Chen Chao5,Zheng Quan6,Lei Sanlin7,Zhong Xiaogang8,Liu Lixin9,Wang Wei10,Wang Qiang11,Li En12,Luo Yuwen4,Zhang Guanrong13,Feng Xingyu12,Li Yong12ORCID,Wang Junjiang12

Affiliation:

1. Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University , Guangzhou, Guangdong, P. R. China

2. Shantou University Medical College , Shantou, Guangdong, P. R. China

3. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology , Wuhan, Hubei, P. R. China

4. Department of General Surgery, Zhujiang Hospital of Southern Medical University , Guangzhou, Guangdong, P. R. China

5. Department of Gastrointestinal Surgery, Huizhou Municipal Central Hospital , Huizhou, Guangdong, P. R. China

6. Department of Gastrointestinal Surgery, Guangdong Second Provincial General Hospital , Guangzhou, Guangdong, P. R. China

7. Department of Gastrointestinal Surgery, The Second Xiangya Hospital of Central South University , Changsha, Hunan, P. R. China

8. Department of Surgical Treatment of Gastrointestinal Hernia and Fistula, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences , Nanning, Guangxi, P. R. China

9. Department of General Surgery, The Third Affiliated Hospital of Southern Medical University , Guangzhou, Guangdong, P. R. China

10. Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine , Guangzhou, Guangdong, P. R. China

11. Department of Gastrointestinal Surgery, Guangzhou First People’s Hospital , Guangzhou, Guangdong, P. R. China

12. Department of Gastrointestinal Surgery, Meizhou People’s Hospital , Meizhou, Guangdong, P. R. China

13. lnformation and Statistics Center, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Southern Medical University , Guangzhou, Guangdong, P. R. China

Abstract

AbstractBackgroundEnhanced recovery after surgery is used in gastrointestinal surgery. This study aimed to access the effects of early liquid drinking (ELD) on gastrointestinal function recovery in patients with gastric cancer (GC) who underwent radical gastrectomy, as high-quality evidence on the outcomes of ELD after gastrectomy is currently lacking.MethodsClinicopathological data of patients with GC from 11 centers were retrospectively analysed. Clinical outcomes were investigated in 555 patients, including 225 who started drinking liquid within 48 h (ELD group) of surgery and 330 who started drinking liquid after flatus resumption (traditional liquid drinking [TLD] group). Propensity score matching (PSM) analysis was performed using a match ratio of 1:1 and 201 patients were selected from each group for the analysis. Primary outcome was time to first passage of flatus. Secondary outcomes included time to first defecation, post-operative hospitalization days, occurrence of short-term post-operative complications, and hospitalization costs.ResultsAfter PSM, baseline characteristics were not significantly different between the two groups. The time to first flatus (2.72 ± 1.08 vs 3.36 ± 1.39 days), first defecation (4.34 ± 1.85 vs 4.77 ± 1.61 days), and post-operative hospital stay (8.27 ± 4.02 vs 12.94 ± 4.43 days) were shorter in the ELD group than in the TLD group (all P < 0.05). The ELD group had lower hospitalization costs than the TLD group ([7.83 ± 2.44 vs 8.78 ± 3.41] × 104 RMB, P = 0.041). No significant differences were observed in the incidence of post-operative complications.ConclusionsCompared with TLD, post-operative ELD could promote rapid recovery of gastrointestinal function and reduce hospitalization costs; moreover, ELD does not increase the risk of post-operative complications.

Funder

Ethicon Excellence in Surgery

National Key Clinical Specialty Construction Project

Publisher

Oxford University Press (OUP)

Subject

Gastroenterology

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