Ann Surg Treat Res.  2020 Oct;99(4):205-212. 10.4174/astr.2020.99.4.205.

Reduced fasting time in patients who underwent totally laparoscopic distal gastrectomy

• Jang S
• Kang A
• Ahn Hm
• Hwang SH
• Lee SH

• KMID: 2506651
• DOI: http://doi.org/10.4174/astr.2020.99.4.205

Abstract

Purpose
The aim of this study was to analyze the effects of reduced fasting time on postoperative recovery in patients who underwent totally laparoscopic distal gastrectomy (TLDG).
Methods
This retrospective study included 347 patients who underwent TLDG. Patients were divided into 2 groups: reduced fasting time group (n = 139) and conventional feeding group (n = 208). We compared the total hospital cost and recovery parameters, such as postoperative complications, mean hospital stay, day of first flatus, initiation of soft diet, and serum CRP levels, between the 2 groups.
Results
The reduced fasting time group had a lower total hospital cost (P < 0.001) than the conventional feeding group. Regarding postoperative complications, there was no significant difference between the 2 groups (P = 0.085). Patients in the reduced fasting time group had a significantly shorter duration of mean hospital stay (P < 0.001), an earlier first flatus (P = 0.002), an earlier initiation of soft diet (P < 0.001), and lower level of serum CRP concentration (day of surgery, P = 0.036; postoperative days 2, 5, and 7, P = 0.01, 0.009, and 0.012, respectively) than patients in the conventional feeding group.
Conclusion
Reduced fasting time can enhance postoperative recovery in patients who undergo TLDG and may reduce medical costs.

Keyword

Enhanced recovery after surgery; Fasting; Gastrectomy; Laparoscopy

Figure

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  Fig. 1 Schematic of the study protocol. CRP, C-reactive protein.

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  Fig. 2 Perioperative changes in C-reactive protein (CRP) concentration after totally laparoscopic distal gastrectomy. Preop, preoperative day; Op. day, operative day; POD, postoperative day.

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