Early Recovery After Gastric Cancer Surgery

Study Overview
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Brief Summary
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Study preparation To progress this prospective study, the investigators analyzed the retrospective data of 426 patients who had been managed with conventional critical pathway after gastric cancer surgery during last 1 year. Through this retrospective analysis, we decided the inclusion criteria which showed significantly the lower complication rate and shorter hospital stay. Method for Prospective study Patients who enroll in this prospective study are administered and are supplied a liquid diet one day before surgery without bowel preparation. After gastric cancer surgery, they start sips of water on postoperative first day, and they are discharged once they exhibit at least three times soft diet without specific complaint and had normal clinical status and physical examination.

Detailed Description
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Enrollment of patients Before the patients are enrolled in this study, they give us informed consents. A liquid diet is supplied beginning from the morning of the day prior to operation to the midnight. Operation and postoperative management All procedures are approached by laparoscopic surgery, and partial gastrectomy with lymph node dissection are performed. The patients who are considered to be difficult to progress early oral feeding in surgical field are excluded from the study. Nasogastric tube is not applied to patients. Postoperative pain is managed by non-opioid pain killer. The patients are started on sips of water on the first postoperative day. If they are tolerable, a liquid diet is started on the second postoperative day, and a soft diet on a third postoperative day for them. We have a plan to discharge the patients on the fourth postoperative day if they exhibit at least three times soft diet without specific complaint and had normal clinical status and physical examination. Evaluation of patients - The patients are followed up to 30 days after discharge from hospital, and we check whether they are tolerable without any compliant and are readmitted.

Official Title
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Prospective Clinical Study for Early Recovery After Gastric Cancer Surgery

Conditions
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Fasting, Malignant Neoplasm of Stomach

Intervention / Treatment
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* Dietary Supplement: Early recovery


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients who are diagnosed with gastric adenocarcinoma 65 years old and blew Patients are expected to be undergone distal subtotal gastrectomy No complication by gastric cancer No synchronous metastatic lesions Laparoscopic or robotic surgery Informed consent Exclusion Criteria: Previous gastrectomy history Combined surgery due to synchronous malignancy Patients with major organ dysfunction

Ages Eligible for Study
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Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Early recovery<br>Patients who enroll in this arm are supplied a liquid diet one day before surgery without bowel preparation. After gastric cancer surgery, they start sips of water on postoperative first day, and they are discharged once they exhibit at least three times soft diet without specific complaint and had normal clinical status and physical examination. | Dietary Supplement: Early recovery<br>* The patients are started on sips of water on the first postoperative day. If they are tolerable, a liquid diet is started on the second postoperative day, and a soft diet on a third postoperative day for them. We have a plan to discharge the patients on the fourth postoperative day if they exhibit at least three times soft diet without specific complaint and had normal clinical status and physical examination.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Drop rate from critical pathway | It is defined as the proportion of dropped patients from 4 days critical pathway | 4 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative pain | It is defined as the change of pain scale after surgery | 7 days | 
| Postoperative complication | It is defined the complications after surgery | 30 days | 
| Postoperative mortality | It will defined as the death case during 30 days after surgery | 30 days | 
| Recovery after surgery | It is defined as the time to first flatus and recovery of bowel activity after surgery | 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Gastric cancer surgery, Early oral feeding, Fast track surgery