Combined Oral and Parenteral Nutritional Therapy After Gastrectomy for Gastric Cancer

Postoperative nutritional deterioration remains a major clinical challenge after gastrectomy for gastric cancer. Reduced gastric capacity and postoperative gastrointestinal symptoms frequently result in inadequate oral intake during the early recovery period. Although oral nutritional supplements are widely recommended, adherence is often poor, potentially leading to insufficient caloric intake and postoperative nutritional deficits.

This prospective randomized clinical trial evaluates whether combined oral and parenteral nutritional therapy can improve postoperative nutritional status and recovery compared with standard postoperative care. Patients undergoing curative gastrectomy for gastric cancer are randomized to receive either combined oral nutritional supplementation plus parenteral nutrition or standard postoperative nutritional management.

Nutritional outcomes including body weight, body mass index, body composition, inflammatory markers, laboratory nutritional parameters, caloric intake, oral nutritional supplement adherence, and quality of life are assessed during the postoperative recovery period.

This study aims to clarify the clinical significance of supplemental parenteral nutrition in bridging the postoperative nutritional gap after gastrectomy.

Inclusion criteria

• Age 20 to 80 years
• Histologically confirmed gastric cancer
• Scheduled for curative total or subtotal gastrectomy
• Ability to tolerate oral intake
• Residence within areas covered by home care services
• Written informed consent

Exclusion criteria

• Body mass index (BMI) ≥30 kg/m² or <18.5 kg/m²
• Uncontrolled diabetes mellitus
• Severe hepatic or renal dysfunction
• Active malignancy other than gastric cancer
• Previous chemotherapy or radiotherapy
• Allergy to oral nutritional supplement products