Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and...

Area of Science:

• Gastroenterology
• Surgical Oncology
• Clinical Nutrition

Background:

• Endoscopic submucosal dissection (ESD) is a widely adopted, effective, and safe procedure for gastric cancer.
• Optimal post-procedure care, specifically feeding protocols, requires further investigation to maximize patient outcomes.
• The impact of early versus delayed feeding on quality of care after ESD is not fully established.

Purpose of the Study:

• To evaluate the evidence comparing early versus delayed feeding after endoscopic submucosal dissection (ESD) for gastric cancer.
• To assess the effects of feeding timing on patient satisfaction, hospital stay, and complication rates.

Main Methods:

• A systematic review of randomized controlled trials was conducted using major electronic databases and trial registries.
• Studies published before September 2020 were included.
• Data extraction and quality assessment followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, focusing on patient satisfaction and hospital stay.

Main Results:

• Two randomized controlled trials involving 239 patients were analyzed.
• No significant difference in post-ESD bleeding rates was observed between early and delayed feeding groups.
• Early feeding was associated with significantly higher patient satisfaction and a shorter hospital stay compared to delayed feeding.

Conclusions:

• Early post-ESD feeding enhances patient satisfaction and reduces hospital stay duration.
• Complication rates, specifically bleeding, did not significantly differ between feeding protocols.
• While promising, the limited number of studies necessitates further research to definitively establish the benefits of early feeding on overall quality of care.