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 journalArticlepeer-review

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.

Original languageEnglish
Pages (from-to)160-169
Number of pages10
JournalDigestion
Volume100
Issue number3
DOIs
Publication statusPublished - 2019 Oct 1

Keywords

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

ASJC Scopus subject areas

  • Gastroenterology

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