Long‐term effects of an oral elemental nutritional supplement on post‐gastrectomy body weight loss in gastric cancer patients (KSES002)

The present study aimed to evaluate the efficacy of short-term nutritional intervention with an oral elemental diet (ED; Elental; EA Pharma Co., Ltd, Tokyo, Japan) at 300 kcal/day for 6-8 weeks in the early post-gastrectomy period on postoperative long-term body weight loss (BWL).We analyzed consecutive patients who were randomly divided to receive the regular diet with or without ED. The control group received regular diet alone post-gastrectomy, whereas the ED group received 300 kcal ED plus regular diet for 6-8 weeks. Primary endpoint was percentage (%) BWL (body weight loss; body weight before surgery minus that at postoperative 1 year) by surgical type. Secondary endpoints included changes in nutrition-related blood parameters.Of the patients in the original trial, 106 were eligible for efficacy analyses. %BWL at postoperative 1 year was significantly lower in the ED group than in the control group among patients who underwent total gastrectomy (TG) (n = 19 and n = 17, respectively; 9.66 ± 5.98% [95% confidence interval, CI: 6.77-12.54] vs 15.11 ± 6.78% [95% CI: 11.63-18.60], P = .015), but not in patients who underwent distal gastrectomy (n = 38 and n = 32, respectively; 5.81 ± 7.91% [95% CI: 3.21-8.41] vs 5.96 ± 6.20% [95% CI: 3.72-8.19], P = .933). In multivariate analysis, ED was the only factor affecting %BWL at postoperative 1 year among patients who underwent TG.Daily nutritional intervention (300 kcal/day ED) for 6-8 weeks reduced %BWL not only at postoperative 6-8 weeks but also at 1 year in patients who underwent TG.