Impact of perioperative enteral nutrition on postoperative acute muscle wasting in gastric cancer: A prospective exploratory study with a historical control group

Xing Zeng^1,2*Xuan Ni³Zhili Shen¹Dong Yang¹Yajing Gu⁴Ai Li⁵Hui Liu^1*Changdi Li^1*

• ¹Department of Gastrointestinal Oncology Surgery, The Affiliated Jiangning Hospital of Nanjing Medical University, nanjing, China
• ²Chinese Hospital Reform and Development Institute, Nanjing University, Nanjing, China
• ³Department of Orthopedics; The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
• ⁴Department of Urology. The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
• ⁵Nursing Department, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China

Objective: Assessing the impact of perioperative enteral nutrition (EN) on postoperative acute muscle atrophy following radical gastrectomy for gastric cancer(GC) (with changes in skeletal muscle mass as the primary outcome indicator). Methods: Patients who underwent GC surgery at the Department of Gastrointestinal Oncology Surgery in a top-tier hospital in Nanjing were selected for the study. The control group, consisting of patients treated between January and June 2023, received routine perioperative nutritional management. The experimental group, consisting of patients treated between July and December 2023, followed a preoperative combined with early postoperative EN program. skeletal muscle mass, grip strength, 6-meter walk test speed, and body weight were compared between the two groups 7 d postoperatively. Results: The intervention significantly reduced the loss of skeletal muscle mass, grip strength, and body weight from baseline (p<0.01). However, no significant differences in 6meter walk test speed were observed between the two groups. After adjusting for confounding factors such as age, gender, nutritional risk screening 2002 (NRS 2002) score, education level, diabetes comorbidity, tumor staging, surgical approach, intraoperative blood loss, and operation time, multivariate linear regression analysis showed that the EN program independently influenced the loss rates of skeletal muscle mass, grip strength, and body weight (p<0.01).The perioperative EN program for GC developed in this study enables medical staff to efficiently gather relevant information, providing a more comprehensive and holistic approach to EN for GC patients. The program effectively reduces postoperative acute muscle wasting, grip strength loss, and weight loss. This study provides a reference for clinical perioperative EN management in GC patients.