Enteral or parenteral feeding after total gastrectomy: prospective randomised pilot study

Eur J Surg. 1997 Oct;163(10):761-6.


Objective: To compare the efficacy and cost of enteral and parenteral feeding after total gastrectomy.

Design: Prospective randomised open study.

Setting: University hospital, Finland.

Subjects: 29 patients undergoing curative total gastrectomy for gastric cancer.

Interventions: 13 patients were given early enteral feeding by nasojejunal tube and 16 patients parenteral nutrition by central venous catheter.

Main outcome measures: Postoperative complications, duration of hospital stay, serum CRP and albumin concentrations, cost, and postoperative abdominal symptoms.

Results: One patient in the enteral feeding group discontinued the study on day 1. Oesophagojejunal leaks developed in one patient in each group. Infective complications occurred in 3 (23%) in the enteral group and 5 (31%) in the parenteral group. Serum CRP concentration on day six was lower in the enteral feeding group than in the parenteral feeding group (32 (16) g/L compared with 61 (41) g/L; p = 0.02). Enteral feeding was well tolerated. Diarrhoea developed earlier in the enteral than in the parenteral group (days 3-5 compared with 5-7, respectively) but there was a tendency to an increased risk of diarrhoea in 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 cheaper than parenteral nutrition.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cost-Benefit Analysis
  • Enteral Nutrition / economics
  • Enteral Nutrition / methods*
  • Female
  • Follow-Up Studies
  • Gastrectomy*
  • Humans
  • Male
  • Middle Aged
  • Parenteral Nutrition, Total / economics
  • Parenteral Nutrition, Total / methods*
  • Pilot Projects
  • Postoperative Complications*
  • Postoperative Period
  • Prospective Studies
  • Stomach Neoplasms / surgery
  • Stomach Neoplasms / therapy*
  • Treatment Outcome