Safety of Early Diet After Endoscopic Full-Thickness Resection of Gastric Tumor: A Propensity Match Analysis

Endoscopic full-thickness resection (EFTR) can effectively remove extraluminal tumors, overcoming limitations of endoscopic submucosal dissection (ESD). However, optimal post-EFTR feeding timing lacks standardized guidelines for patients with gastric tumors. This study aims to assess the safety of early feeding after EFTR.

Retrospective analysis was conducted on patients who underwent EFTR at our hospital between January 2014 and January 2019. Based on actual fasting duration, patients were categorized: short fasting (≤ 2 days, n = 72) and long fasting (> 2 days, n = 431) group. Using 1:1 propensity score matching, postoperative complications and hospital stay were compared between balanced groups.

A total of 503 patients were included in this study, among which 72 were in the short fasting group and 431 were in the long fasting group. After matching, the baseline characteristics of 68 patients in the short fasting group and 68 patients in the long fasting group reached equilibrium (P > 0.05). The average age was 53.82 ± 10.98 years old. There was no significant difference in clinicopathological conditions or lesion size between the two groups. There was no statistically significant difference in the rates of postoperative bleeding, fever and abdominal distension between the two groups of patients after EFTR. However, compared with the long fasting protocol, a trend of shorter hospitalization was observed in the short fasting group.

Compared with the long fasting protocol, early feeding after EFTR for gastric tumors did not increase the incidence of discomfort or postoperative complications. In addition, short fasting protocol has a tendency to shorten hospital stays, which represents potential clinical benefits.