Yang Dongjie, Hou Xun, Fu Huafeng, Song Wu, Dong Wenqing, Wang Hu, Mao Yuantian, Li Mengbin, Chen Junqiang, He Yulong
Digestive Medicine Center, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, P. R. China.
Guangdong Provincial Key Laboratory of Digestive Cancer Research, Shenzhen, Guangdong, P. R. China.
Gastroenterol Rep (Oxf). 2024 Sep 12;12:goae077. doi: 10.1093/gastro/goae077. eCollection 2024.
Carbohydrate drinking 2-3 hours before surgery has been widely adopted in colorectal operations. However, there is little direct evidence regarding its application in gastric cancer surgery. We aimed to evaluate the gastric residual volume, safety, and effectiveness of drinking 250 mL of 5% glucose solution 2-3 hours before elective gastric cancer surgery.
We conducted an investigator-initiated, multicenter, randomized-controlled, parallel group, and equivalence trial. Eighty-eight patients with gastric adenocarcinoma were randomized into study or control group. Patients in the control group followed the traditional routine of 6-8 hours preoperative fasting, while those in the study group drank 250 mL of 5% glucose solution 2-3 hours before surgery. Immediately following tracheal intubation, gastric contents were aspirated through gastroscopy. The primary outcome was preoperative gastric residual volume.
Eighty-three patients were eventually analysed in the study (42 in the study group and 41 in the control group). Two groups were comparable at baseline characteristics. There were no statistical differences in residual gastric fluid volumes (35.86 ± 27.13 vs 27.70 ± 20.37 mL, =0.135) and pH values (2.81 ± 1.99 vs 2.66 ± 1.68, =0.708) between the two groups. Preoperative discomfort was significantly more decreased in the study group than in the control group (thirst score: 1.49 ± 1.23 vs 4.14 ± 2.07, <0.001; hunger score: 1.66 ± 1.18 vs 3.00 ± 2.32, =0.007). There was no statistical difference in the incidence of postoperative complications (19.05% vs 17.07%, =0.815).
Drinking 250 mL of 5% glucose solution 2-3 hours before surgery in elective gastric cancer patients shows benefits in lowering thirst and hunger scores without increasing gastric residual volume and perioperative complications.
术前2 - 3小时饮用碳水化合物在结直肠手术中已被广泛采用。然而，关于其在胃癌手术中的应用，几乎没有直接证据。我们旨在评估择期胃癌手术前2 - 3小时饮用250毫升5%葡萄糖溶液后的胃残余量、安全性及有效性。
我们开展了一项由研究者发起的多中心、随机对照、平行组等效性试验。88例胃腺癌患者被随机分为研究组或对照组。对照组患者遵循术前禁食6 - 8小时的传统常规，而研究组患者在手术前2 - 3小时饮用250毫升5%葡萄糖溶液。气管插管后立即通过胃镜抽吸胃内容物。主要结局指标为术前胃残余量。
最终83例患者纳入研究分析（研究组42例，对照组41例）。两组基线特征具有可比性。两组间残余胃液量（35.86±27.13 vs 27.70±20.37毫升，P = 0.135）及pH值（2.81±1.99 vs 2.66±1.68，P = 0.708）无统计学差异。研究组术前不适较对照组显著减轻（口渴评分：1.49±1.23 vs 4.14±2.07，P < 0.001；饥饿评分：1.66±1.18 vs 3.00±2.32，P = 0.007）。术后并发症发生率无统计学差异（19.05% vs 17.07%，P = 0.815）。
择期胃癌患者术前2 - 3小时饮用250毫升5%葡萄糖溶液，在降低口渴和饥饿评分方面有益，且不增加胃残余量及围手术期并发症。
