Effects of Early Initiation of Solid Versus Liquid Diet after Endoscopic Submucosal Dissection on Quality of Life and Postoperative Outcomes: A Prospective Pilot Randomized Controlled Trial

Akihiro Miyakawa, Satoshi Kodera, Yukie Sakuma, Taro Shimada, Manabu Kubota, Akira Nakamura, Ei Itobayashi, Haruhisa Shimura, Yoshio Suzuki, Yasunori Sato, Kenji Shimura

Research output: Contribution to journalArticle

Abstract

Background/Aims: Feeding recommendations after endoscopic submucosal dissection (ESD) for gastric neoplasms are not established and based on clinical experience. Methods: This was a prospective pilot randomized controlled trial. Patients undergoing ESD for gastric neoplasms were randomly assigned to solid (n = 50) or liquid diet (n = 50) groups. Beginning the day after hemostasis confirmation until discharge, the solid diet group started on a diet of rice porridge, whereas the liquid diet group started on a liquid diet, with gradual transition to solid food. The primary endpoint was delayed bleeding rate. The secondary endpoints were quality of life (QOL), ulcer-stage, hospital fees, and post-ESD symptoms. Results: Delayed bleeding occurred in the solid diet group (2%) but not in the liquid diet group. The QOL evaluation using European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-STO22 showed better score in the solid diet group. The patients who felt dietary restriction at discharge was of a larger number in the liquid diet group (p = 0.019). More patients experienced appetite loss (p = 0.038), constipation (p = 0.022), and dietary restriction (p = 0.037) in the liquid diet group during hospitalization. The other endpoints were equivalent between the groups. Conclusion: Early initiation of solid foods after ESD is feasible and associated with higher QOL, potentially rendering conventional liquid diets unnecessary, although additional studies are needed (Trial registration number: UMIN000013297).

Original languageEnglish
JournalDigestion
DOIs
Publication statusAccepted/In press - 2018 Jan 1

Fingerprint

Randomized Controlled Trials
Quality of Life
Diet
Stomach Neoplasms
Endoscopic Mucosal Resection
Hospitalization Insurance
Hemorrhage
Food
Fees and Charges
Appetite
Constipation
Hemostasis
Ulcer
Organizations
Research

Keywords

  • Early solid diet
  • Endoscopic submucosal dissection
  • Enhanced recovery after surgery
  • Gastric neoplasms
  • Quality of life

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Effects of Early Initiation of Solid Versus Liquid Diet after Endoscopic Submucosal Dissection on Quality of Life and Postoperative Outcomes : A Prospective Pilot Randomized Controlled Trial. / Miyakawa, Akihiro; Kodera, Satoshi; Sakuma, Yukie; Shimada, Taro; Kubota, Manabu; Nakamura, Akira; Itobayashi, Ei; Shimura, Haruhisa; Suzuki, Yoshio; Sato, Yasunori; Shimura, Kenji.

In: Digestion, 01.01.2018.

Research output: Contribution to journalArticle

Miyakawa, Akihiro ; Kodera, Satoshi ; Sakuma, Yukie ; Shimada, Taro ; Kubota, Manabu ; Nakamura, Akira ; Itobayashi, Ei ; Shimura, Haruhisa ; Suzuki, Yoshio ; Sato, Yasunori ; Shimura, Kenji. / Effects of Early Initiation of Solid Versus Liquid Diet after Endoscopic Submucosal Dissection on Quality of Life and Postoperative Outcomes : A Prospective Pilot Randomized Controlled Trial. In: Digestion. 2018.
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abstract = "Background/Aims: Feeding recommendations after endoscopic submucosal dissection (ESD) for gastric neoplasms are not established and based on clinical experience. Methods: This was a prospective pilot randomized controlled trial. Patients undergoing ESD for gastric neoplasms were randomly assigned to solid (n = 50) or liquid diet (n = 50) groups. Beginning the day after hemostasis confirmation until discharge, the solid diet group started on a diet of rice porridge, whereas the liquid diet group started on a liquid diet, with gradual transition to solid food. The primary endpoint was delayed bleeding rate. The secondary endpoints were quality of life (QOL), ulcer-stage, hospital fees, and post-ESD symptoms. Results: Delayed bleeding occurred in the solid diet group (2{\%}) but not in the liquid diet group. The QOL evaluation using European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-STO22 showed better score in the solid diet group. The patients who felt dietary restriction at discharge was of a larger number in the liquid diet group (p = 0.019). More patients experienced appetite loss (p = 0.038), constipation (p = 0.022), and dietary restriction (p = 0.037) in the liquid diet group during hospitalization. The other endpoints were equivalent between the groups. Conclusion: Early initiation of solid foods after ESD is feasible and associated with higher QOL, potentially rendering conventional liquid diets unnecessary, although additional studies are needed (Trial registration number: UMIN000013297).",
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AU - Miyakawa, Akihiro

AU - Kodera, Satoshi

AU - Sakuma, Yukie

AU - Shimada, Taro

AU - Kubota, Manabu

AU - Nakamura, Akira

AU - Itobayashi, Ei

AU - Shimura, Haruhisa

AU - Suzuki, Yoshio

AU - Sato, Yasunori

AU - Shimura, Kenji

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N2 - Background/Aims: Feeding recommendations after endoscopic submucosal dissection (ESD) for gastric neoplasms are not established and based on clinical experience. Methods: This was a prospective pilot randomized controlled trial. Patients undergoing ESD for gastric neoplasms were randomly assigned to solid (n = 50) or liquid diet (n = 50) groups. Beginning the day after hemostasis confirmation until discharge, the solid diet group started on a diet of rice porridge, whereas the liquid diet group started on a liquid diet, with gradual transition to solid food. The primary endpoint was delayed bleeding rate. The secondary endpoints were quality of life (QOL), ulcer-stage, hospital fees, and post-ESD symptoms. Results: Delayed bleeding occurred in the solid diet group (2%) but not in the liquid diet group. The QOL evaluation using European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-STO22 showed better score in the solid diet group. The patients who felt dietary restriction at discharge was of a larger number in the liquid diet group (p = 0.019). More patients experienced appetite loss (p = 0.038), constipation (p = 0.022), and dietary restriction (p = 0.037) in the liquid diet group during hospitalization. The other endpoints were equivalent between the groups. Conclusion: Early initiation of solid foods after ESD is feasible and associated with higher QOL, potentially rendering conventional liquid diets unnecessary, although additional studies are needed (Trial registration number: UMIN000013297).

AB - Background/Aims: Feeding recommendations after endoscopic submucosal dissection (ESD) for gastric neoplasms are not established and based on clinical experience. Methods: This was a prospective pilot randomized controlled trial. Patients undergoing ESD for gastric neoplasms were randomly assigned to solid (n = 50) or liquid diet (n = 50) groups. Beginning the day after hemostasis confirmation until discharge, the solid diet group started on a diet of rice porridge, whereas the liquid diet group started on a liquid diet, with gradual transition to solid food. The primary endpoint was delayed bleeding rate. The secondary endpoints were quality of life (QOL), ulcer-stage, hospital fees, and post-ESD symptoms. Results: Delayed bleeding occurred in the solid diet group (2%) but not in the liquid diet group. The QOL evaluation using European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-STO22 showed better score in the solid diet group. The patients who felt dietary restriction at discharge was of a larger number in the liquid diet group (p = 0.019). More patients experienced appetite loss (p = 0.038), constipation (p = 0.022), and dietary restriction (p = 0.037) in the liquid diet group during hospitalization. The other endpoints were equivalent between the groups. Conclusion: Early initiation of solid foods after ESD is feasible and associated with higher QOL, potentially rendering conventional liquid diets unnecessary, although additional studies are needed (Trial registration number: UMIN000013297).

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