Tu1297 Pilot Study to Assess the Safety and Patient Satisfaction of Early Diet After Endoscopic Submucosal Dissection for Gastric Neoplasm

Pilot Study to Assess the Safety and Patient Satisfaction of Early Diet After Endoscopic Submucosal Dissection for Gastric Neoplasm Sunyong Kim*, Kyung Seok Cheoi, Hyun Jik Lee, Choong Nam Shim, Hyuk Lee, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee, Jun Chul Park Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea Background: Endoscopic submucosal dissection(ESD) is a standard treatment for gastric neoplasm without LN metastasis limited to mucosa. However, there is neither standardized guideline nor research with regard to adequate time to start oral intake after ESD. Methods: A total of 130 patients who underwent ESD for 156 gastric neoplasms by single expert endoscopist were consecutively enrolled prospectively from February 2011 to January 2012. Enrolled patients were radonmized to early diet group and fasting group. In the course of study, 9 patients were excluded. Early diet group starts their meal as clear liquid diet on day 0 and as tolerable diet on day 1. Fasting group kept on fasting for two days. All patients were underwent 2nd look upper endoscopy within 2 days and follow-up upper endoscopy after 2 months after ESD. Results: Total number of early diet group and fasting group were 63 and 57 patients, respectively. Mean age was 62 year ( 9.41). All the gastric lesions were resected by en bloc (100%) and most of them by complete resection (94.17%). Pathologic diagnosis revealed malignancy in 57 cases and dysplasia in 60 cases. Mean size of resected specimen was 42.74 mm ( 17.66). There are no significant difference in clinicopathologic conditions and technical detailes between two groups. There was no significant differences of the increment of abdominal pain score and the rates of bleeding (4.76% vs 3.51%, respectively, p .732) and healing rates of post-ESD ulcer between two groups. However, early diet provided significantly higher patient satisfaction and lower hospital costs compared with fasting protocol (both p 0.001). Conclusion: Post-ESD early diet protocol provides higher patient satisfaction and cost-effectiveness and does not influence on the complication rates such as bleeding or abdominal pain. Our study supports that long period of post-ESD fasting might not be recommended unnecessarily.