Evaluation of early liquid drinking after radical gastrectomy in gastric cancer: a Chinese multicenter propensity score matching analysis

Yue Zhang; Kaixiong Tao; Jinlong Yu; Chao Chen; Quan Zheng; Sanlin Lei; Xiaogang Zhong; Lixin Liu; Wei Wang; Qiang Wang; En Li; Yuwen Luo; Guanrong Zhang; Xingyu Feng; Yong Li; Junjiang Wang

doi:10.1093/gastro/goad029

Evaluation of early liquid drinking after radical gastrectomy in gastric cancer: a Chinese multicenter propensity score matching analysis

Gastroenterol Rep (Oxf). 2023 Jun 8:11:goad029. doi: 10.1093/gastro/goad029. eCollection 2023.

Authors

Yue Zhang^{1

2}, Kaixiong Tao³, Jinlong Yu⁴, Chao Chen⁵, Quan Zheng⁶, Sanlin Lei⁷, Xiaogang Zhong⁸, Lixin Liu⁹, Wei Wang¹⁰, Qiang Wang¹¹, En Li¹², Yuwen Luo⁴, Guanrong Zhang¹³, Xingyu Feng^{1

2}, Yong Li^{1

2}, Junjiang Wang^{1

2}

Affiliations

¹ Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong, P. R. China.
² Shantou University Medical College, Shantou, Guangdong, P. R. China.
³ Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, P. R. China.
⁴ Department of General Surgery, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, P. R. China.
⁵ Department of Gastrointestinal Surgery, Huizhou Municipal Central Hospital, Huizhou, Guangdong, P. R. China.
⁶ Department of Gastrointestinal Surgery, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, P. R. China.
⁷ Department of Gastrointestinal Surgery, The Second Xiangya Hospital of Central South University, Changsha, Hunan, P. R. China.
⁸ Department of Surgical Treatment of Gastrointestinal Hernia and Fistula, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, Guangxi, P. R. China.
⁹ Department of General Surgery, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, P. R. China.
¹⁰ Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, Guangdong, P. R. China.
¹¹ Department of Gastrointestinal Surgery, Guangzhou First People's Hospital, Guangzhou, Guangdong, P. R. China.
¹² Department of Gastrointestinal Surgery, Meizhou People's Hospital, Meizhou, Guangdong, P. R. China.
¹³ lnformation and Statistics Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong, P. R. China.

Abstract

Background: Enhanced recovery after surgery is used in gastrointestinal surgery. This study aimed to access the effects of early liquid drinking (ELD) on gastrointestinal function recovery in patients with gastric cancer (GC) who underwent radical gastrectomy, as high-quality evidence on the outcomes of ELD after gastrectomy is currently lacking.

Methods: Clinicopathological data of patients with GC from 11 centers were retrospectively analysed. Clinical outcomes were investigated in 555 patients, including 225 who started drinking liquid within 48 h (ELD group) of surgery and 330 who started drinking liquid after flatus resumption (traditional liquid drinking [TLD] group). Propensity score matching (PSM) analysis was performed using a match ratio of 1:1 and 201 patients were selected from each group for the analysis. Primary outcome was time to first passage of flatus. Secondary outcomes included time to first defecation, post-operative hospitalization days, occurrence of short-term post-operative complications, and hospitalization costs.

Results: After PSM, baseline characteristics were not significantly different between the two groups. The time to first flatus (2.72 ± 1.08 vs 3.36 ± 1.39 days), first defecation (4.34 ± 1.85 vs 4.77 ± 1.61 days), and post-operative hospital stay (8.27 ± 4.02 vs 12.94 ± 4.43 days) were shorter in the ELD group than in the TLD group (all P < 0.05). The ELD group had lower hospitalization costs than the TLD group ([7.83 ± 2.44 vs 8.78 ± 3.41] × 10⁴ RMB, P = 0.041). No significant differences were observed in the incidence of post-operative complications.

Conclusions: Compared with TLD, post-operative ELD could promote rapid recovery of gastrointestinal function and reduce hospitalization costs; moreover, ELD does not increase the risk of post-operative complications.

Keywords: early liquid drinking; gastric cancer; gastrointestinal function; propensity score matching; traditional liquid drinking.