Nakaseko Yuichi, Ohdaira Hironori, Yoshida Masashi, Kitajima Masaki, Suzuki Yutaka
International University of Health and Welfare Hospital, Department of Surgery, 537-3 Iguchi Nasushiobara, Tochigi 329-2763, Japan.
Ann Med Surg (Lond). 2018 Apr 3;31:20-24. doi: 10.1016/j.amsu.2018.03.023. eCollection 2018 Jul.
We investigated the validity of the clinical pathway of early oral intake using a special type of food "iEat™" for patients after laparoscopic gastric cancer surgery.
Fifty-two patients who underwent laparoscopic surgery for gastric cancer between April 2012 and October 2013 were the participants. We provided postoperative care in accordance with a clinical pathway for laparoscopic gastrectomy that begins oral intake with "iEat™ the day after surgery. We examined complications resulting from oral intake, postoperative complications, and the length of postoperative hospital stay.
Of the 52 patients, 30 underwent distal gastrectomy and 22 underwent total gastrectomy. 50 patients was able to start early oral intake in accordance with our clinical pathway. No anastomotic leak complications were observed, and 9 patients (17.3%) developed complications as results of surgery. There was no complication related to early oral intake with "iEat™". Re-operation were performed in two cases. Overall mean and median postoperative hospital stays were 8.3 days and 6 days, respectively. There was a single case of hospital re-admission. The completion rate of this early oral intake clinical pathway was 86.5%.
Clinical pathway of recovery program combined laparoscopic suregry and early oral intake with "iEat™" could be useful for gastric cancer. This study indicates that using non-liquid food like iEat™ can be feasiblel, and water or liquid food don't have to be used in early oral feeding after laparoscopic gastrectomy.
我们使用一种特殊的食物“iEat™”，对腹腔镜胃癌手术后的患者早期经口进食的临床路径的有效性进行了研究。
选取2012年4月至2013年10月间接受腹腔镜胃癌手术的52例患者作为研究对象。我们按照腹腔镜胃切除术的临床路径提供术后护理，术后第一天开始经口进食“iEat™”。我们检查了经口进食引起的并发症、术后并发症以及术后住院时间。
52例患者中，30例行远端胃切除术，22例行全胃切除术。50例患者能够按照我们的临床路径开始早期经口进食。未观察到吻合口漏并发症，9例患者（17.3%）出现手术相关并发症。未出现与使用“iEat™”进行早期经口进食相关的并发症。2例患者进行了再次手术。术后总体平均住院时间和中位住院时间分别为8.3天和6天。有1例患者再次入院。这种早期经口进食临床路径的完成率为86.5%。
结合腹腔镜手术和使用“iEat™”进行早期经口进食的康复计划临床路径可能对胃癌患者有用。本研究表明，使用像iEat™这样的非流质食物是可行的，腹腔镜胃切除术后早期经口喂养不必使用水或流质食物。
