ENTERAL OR PARENTERAL-FEEDING AFTER TOTAL GASTRECTOMY - PROSPECTIVE RANDOMIZED PILOT-STUDY

Objective: To compare the efficacy and cost of enteral and parenteral feeding after total gastrectomy. Design: Prospective randomised open s tudy. Setting: University hospital, Finland. Subjects: 29 patients und ergoing curative total gastrectomy for gastric cancer. Interventions: 13 patients were given early enteral feeding by nasojejunal tube and 1 6 patients parenteral nutrition by central venous catheter. Main outco me measures: Postoperative complications, duration of hospital stay, s erum CRP and albumin concentrations, cost, and postoperative abdominal symptoms. Results: One patient in the enteral feeding group discontin ued the study on day 1. Oesophagojejunal leaks developed in one patien t in each group. Infective complications occurred in 3 (23%) in the en teral group and 5 (31%) in the parenteral group. Serum CRP concentrati on on day six was lower in the enteral feeding group than in the paren teral feeding group (32 (16) g/L compared with 61 (41) g/L; p=0.02). E nteral feeding was well tolerated. Diarrhoea developed earlier in the enteral than in the parenteral group (days 3-5 compared with 5-7, resp ectively) but there was a tendency to an increased risk of diarrhoea i n the parenteral group. Parenteral feeding was more than four times as expensive as enteral feeding. Conclusion: Enteral nasojejunal feeding is safe and well tolerated after total gastrectomy. It is also cheape r than parenteral nutrition.