Outcomes of patients with cancer receiving early feeding following gastric, small intestinal or colorectal surgery

Early enteral nutrition (EEN) has been shown to the improve clinical outcomes of patients undergoing gastrointestinal surgery worldwide. However, its implementation remains inconsistent in certain countries, particularly among patients with gastrointestinal cancer. The present study aimed to provide further evidence of the outcomes of patients receiving EEN. The present prospective descriptive study included 256 patients with cancer indicated for gastric, small intestine and colorectal surgery. EEN was initiated within 72 h post-operatively, and dietary intake was monitored over the subsequent 7 days. The key outcomes assessed were post‑operative weight change, digestive symptoms, time to initiate enteral nutrition, early postoperative complications, the length of hospitalization and the daily dietary intake of energy and protein. The average time to initiate digestion was 34.7±16.1 h. The mean post‑operative weight loss was 0.6 kg at day 7 compared to the pre‑operative weight. The incidence of abdominal distension and diarrhea was 7.4 and 4.7%, respectively. Patients with abdominal distension had a 5‑fold higher risk of experiencing weight loss than those without (P<0.05). The complication rate was 0.4%. The mean length of hospitalization was 7.12 days. Peak nutritional intake was recorded on post‑operative day 4, reaching 1370.8±310.8 kcal/day (26.5±7.3 kcal/kg/day). In particular, the total energy intake in the diabetic group was consistently lower than in the non‑diabetic group, with statistically significant differences on the majority of post‑operative days (P<0.05). These findings demonstrate the feasibility and clinical benefits of early enteral nutrition following surgery for gastrointestinal cancer, particularly when evaluating outcomes such as weight loss, complication rate, length of hospitalization and dietary intake. Moreover, these results further emphasize the importance of nutritional interventions for patients with cancer with diabetes specifically.