[Effects of Early Enteral Nutrition After Total Gastrectomy for Gastric Cancer].

[The impact of early postoperative enteral nutrition on nutritional status and immune function in breast cancer patients after neoadjuvant therapy].

P1.143. Effectiveness of 3-Months of Home Enteral Nutrition After Esophagectomy for Esophageal Cancer

Esophageal Cancer: Other After esophagectomy for esophageal cancer, postoperative weight loss and sarcopenia are common and associated with poor prognosis. Although enteral nutrition is recommended when oral intake is insufficient, the effectiveness and optimal duration of home enteral nutrition remain unclear. This retrospective single-center study included patients with thoracic esophageal cancer who underwent radical McKeown esophagectomy with gastric tube reconstruction and jejunostomy between March 2023 and December 2024. Patients with recorded body weight data preoperatively and at 3 months postoperatively were eligible. Enteral nutrition (EN) was initiated on postoperative day 1 and continued after discharge at a target of 600 kcal/day for 90 days. Nutritional counseling was provided monthly, and body composition was assessed using bioelectrical impedance analysis. Resting energy expenditure was calculated using the Schofield equation with an activity factor of 1.3. Patients were stratified based on EN/ONS intake (≥600 vs <600 kcal/day), oral intake (≥50% vs <50% of TEE), and total energy intake (≥75% vs <75% of TEE). Changes in body weight and skeletal muscle mass over 90 days were analyzed. Overall, 16 (41.0%) patients completed the 600 kcal/day target. They experienced significantly less weight loss at 3 months than the non-completion group (−7.6% vs −10.5%, p = 0.03). Oral intake sufficiency (≥ 50% of estimated energy requirements) was associated with a favorable trend in body weight and skeletal muscle mass changes. Achieving ≥ 75% of total energy expenditure was significantly associated with reduced weight (−7.9% vs −19.6%, p = 0.002) and muscle loss (−5.4% vs −12.3%, p = 0.01). In patients with insufficient oral intake, supplementation ≥ 600 kcal/day effectively reduced both weight and muscle loss. In conclusion, nutritional supplementation during the 3 months after esophagectomy was associated with preservation of body weight and skeletal muscle mass, with total energy intake showing the strongest effect. Supplementation of approximately 600 kcal/day was particularly beneficial for patients with insufficient oral intake. This structured approach incorporating nutritional counseling and BIA may provide a practical benchmark for postoperative nutritional management.

Micronutrient deficiencies after gastrectomy for gastric cancer.

Early oral nutritional supplementation combined with graded functional exercise for postoperative recovery in patients undergoing pancreaticoduodenectomy.

INTRODUCTION pancreaticoduodenectomy (PD) leads to high malnutrition and complication rates, while early oral nutritional supplementation (ONS) and graded exercise each benefit postoperative recovery. OBJECTIVE to assess the effects of ONS combined with graded functional exercise on postoperative recovery in patients with pancreatic neoplasms undergoing PD. METHODS a total of 87 patients with pancreatic neoplasms admitted between June 2024 and December 2025 were enrolled and randomly assigned to a control group (n = 43) and an intervention group (n = 44). The control group received standard postoperative Enhanced Recovery After Surgery (ERAS) care, whereas the intervention group received early ONS combined with graded functional exercise initiated within 48 hours postoperatively in addition to standard ERAS care. RESULTS when compared with the control group, the intervention group demonstrated significantly shorter time to oral feeding, time to first flatus, time to first defecation, and time to first ambulation (p < 0.05). Serum prealbumin levels on postoperative day 7 were significantly higher in the intervention group (p < 0.05). By postoperative day 14, the intervention group exhibited significantly higher levels of serum prealbumin, albumin, and hemoglobin, along with improved skeletal muscle mass, handgrip strength, and calf circumference compared with the control group (p < 0.05). CONCLUSION early initiation of ONS combined with graded functional exercise following PD in patients with pancreatic neoplasms was associated with improved postoperative nutritional status, attenuation of skeletal muscle loss, and enhanced recovery of gastrointestinal and physical function, thereby supporting subsequent treatment.

Role of Enteral Nutrition in Neoadjuvant Therapy for Locally Advanced Gastric Cancer with Pyloric Obstruction: A Case Series

Objective: To evaluate whether neoadjuvant therapy can be carried out in pyloric obstruction secondary to gastric cancer through nasojejunal enteral nutrition and assess tumor regression and improvement in surgical outcomes.Material and Methods: A retrospective cohort analysis of patients diagnosed with locally advanced gastric cancer (LAGC) with pyloric obstruction who received preoperative nutritional support via nasojejunal tube feeding. Once nutritional adequacy was achieved, patients proceeded to neoadjuvant therapy consisting of S-1 plus oxaliplatin (SOX chemotherapy), targeted therapy with apatinib, and immunotherapy with sintilimab. Tumor and lymph node responses were assessed radiologically and confirmed by postoperative pathological analysis.Results: Enteral feeding was well tolerated without major complications, and all patients were able to complete the neoadjuvant regimen. Imaging showed dramatic shrinkage of the tumor mass and regression of regional lymph node enlargement. After surgery, certain cases yielded a result of complete tumor regression (Tumor Regression Grade 0) in the pathology, including resolution of lymph node metastases. Clinical results established that nutritional optimization helped in the effective downstaging of tumors and thus improved the chances of R0 resection.Conclusion: Nasoenteric enteral nutrition is a feasible and effective method to enable the safe delivery of neoadjuvant therapy in patients with pyloric obstruction resulting from gastric cancer. It optimizes nutrition, enhances treatment tolerance, and contributes to favorable oncologic outcomes.  

OA01.7. Impact of Early Enteral Feeding on Digestive Function Recovery After Esophagectomy: A Prospective Randomized Study

Esophageal Cancer: Surgical Treatment of Esophageal Cancer Esophageal cancer is a common malignancy worldwide, with a five-year survival rate of 5-15%, which may increase to nearly 40% following surgical resection. However, esophagectomy with reconstruction remains a high-risk procedure associated with postoperative organ dysfunction, particularly impaired gastrointestinal function. The safety and benefits of early enteral feeding after esophagectomy remain controversial due to concerns regarding anastomotic healing and delayed gastric emptying, balanced against the potential advantages of preventing intestinal mucosal atrophy and reducing postoperative inflammation. Therefore, this study aimed to investigate the effects of early enteral nutrition on postoperative recovery and inflammatory response following esophagectomy with reconstruction. This prospective randomized study enrolled 70 patients with esophageal cancer undergoing minimally invasive esophagectomy with reconstruction and jejunostomy. Patients were randomly assigned to an experimental group (n = 35) or a control group (n = 35). In the experimental group, enteral feeding via jejunostomy was initiated within 24 hours postoperatively. In the control group, enteral feeding was initiated after the first postoperative bowel movement according to routine care. The primary outcome was time to first postoperative bowel movement. Secondary outcomes included postoperative inflammatory and infection-related markers (C-reactive protein, procalcitonin, and neutrophil percentage), length of stay in the intensive care unit, total hospital length of stay, and postoperative complications. The experimental group demonstrated a significantly shorter time to first postoperative bowel movement compared with the control group (46.95 ± 33.1 vs. 69.12 ± 33.5 hours, p < 0.001). Postoperative C-reactive protein levels were significantly lower in the experimental group (8.24 ± 5.49 vs. 15.0 ± 6.89 mg/dL, p < 0.001). Infection-related markers, including procalcitonin (0.38 ± 0.38 vs. 0.83 ± 1.36 ng/mL, p = 0.043) and neutrophil percentage (84.56 ± 4.20% vs. 87.07 ± 5.20%, p = 0.007), were also significantly reduced. The length of stay in the intensive care unit was significantly shorter in the experimental group (5.34 ± 4.30 vs. 9.88 ± 11.88 days, p < 0.001), whereas total hospital length of stay did not differ significantly between groups. No significant differences were observed in the incidence of pneumonia or anastomotic leakage. Compared with conventional postoperative feeding protocols, early enteral feeding improves gastrointestinal functional recovery, reduces inflammatory and infection-related responses, and shortens intensive care unit stay in patients undergoing esophagectomy with reconstruction.