Staged Post-gastric Cancer Nutritional Management: Quantitative Target，Dynamic Feedback，and Application

Lianwei LIU; Aoran FAN; Xin YAO; Xiumin ZHANG

Article Contents

Article Navigation > Journal of Kunming Medical University > 2026 > Accepted Manuscript

Lianwei LIU, Aoran FAN, Xin YAO, Xiumin ZHANG. Staged Post-gastric Cancer Nutritional Management: Quantitative Target，Dynamic Feedback，and Application[J]. Journal of Kunming Medical University.

Citation:

Lianwei LIU, Aoran FAN, Xin YAO, Xiumin ZHANG. Staged Post-gastric Cancer Nutritional Management: Quantitative Target，Dynamic Feedback，and Application[J]. Journal of Kunming Medical University.

Lianwei LIU, Aoran FAN, Xin YAO, Xiumin ZHANG. Staged Post-gastric Cancer Nutritional Management: Quantitative Target，Dynamic Feedback，and Application[J]. Journal of Kunming Medical University.

Citation:

Lianwei LIU, Aoran FAN, Xin YAO, Xiumin ZHANG. Staged Post-gastric Cancer Nutritional Management: Quantitative Target，Dynamic Feedback，and Application[J]. Journal of Kunming Medical University.

PDF( 726 KB)

Staged Post-gastric Cancer Nutritional Management: Quantitative Target，Dynamic Feedback，and Application

Lianwei LIU^{1, 2},
Aoran FAN³,
Xin YAO²,
Xiumin ZHANG^{4
,
,}

1.
Department of Gastrointestinal Oncology Surgery，People’s Hospital of Xinjiang Uygur Autonomous Region，Urumqi Xinjiang 830000
2.
School of Nursing，Xinjiang Medical University，Urumqi Xinjiang 830000
3.
Department of Hepatobiliary Surgery
4.
Nursing Department，People's Hospital of Xinjiang Uygur Autonomous Region，Urumqi Xinjiang 830000，China

Received Date: 2026-05-24

Abstract

Abstract

Objective To develop a staged nutritional management pathway for postoperative gastric cancer patients based on quantitative goals and dynamic feedback, and to explore its effects on improving the attainment rate of early postoperative energy and protein intake, as well as its impact on early postoperative nutrition-related indicators and recent clinical outcomes. Methods This was a quasi-experimental study. Using convenience sampling, 45 patients who underwent laparoscopic radical gastrectomy at a tertiary Grade A hospital in Urumqi, Xinjiang, from September 2025 to December 2025 were selected as the intervention group, and 45 patients who underwent laparoscopic radical gastrectomy admitted from May 2025 to August 2025 were selected as the control group. The control group received routine perioperative nutritional care without explicit quantitative targets or a dynamic feedback mechanism; the intervention group received a staged nutritional management pathway based on quantitative goals and dynamic feedback. The core interventions included staged quantification of dietary substrates, dynamic assessment of gastrointestinal tolerance, and stepwise feedback-based adjustment of the nursing plan. The two groups were compared in terms of early nutritional intake attainment rates, biochemical indicators, postoperative complications, and changes in nutritional risk. Results The energy intake attainment rate in the intervention group was 84.4%, higher than 48.9% in the control group（χ² = 12.80, P < 0.001）; the protein intake attainment rate was 80.0%, higher than 44.4% in the control group （χ² = 12.10, P < 0.001）. On postoperative day 3, serum ALB level in the intervention group was significantly higher than that in the control group [（36.06 ± 4.96） g/L vs （32.47 ± 3.98） g/L, t = 3.783, P < 0.001]. The overall incidence of postoperative complications was 17.78% in the intervention group and 35.56% in the control group, with no statistically significant difference between the two groups （χ² = 3.636, P = 0.057）, According to the Clavien-Dindo classification, the distribution of complications showed no statistically significant difference between the two groups （χ² = 3.636, P = 0.162）. On postoperative day 5, the median NRS-2002 score in the intervention group （distribution more concentrated in the lower score range） was significantly lower than that in the control group [1 （1, 1） vs 1 （1, 2）, Z = -2.051, P = 0.040]. Conclusion The staged nutritional management pathway based on quantitative goals and dynamic feedback can significantly improve the attainment rate of early energy and protein intake in postoperative gastric cancer patients and reduce short-term nutritional risk by defining stage-specific quantitative targets and introducing dynamic feedback adjustments. This pathway may provide a clinical reference for the refined and standardized implementation of perioperative nutritional management in enhanced recovery after surgery （ERAS）.
- Gastric cancer,
- Nutritional management,
- Energy intake,
- Protein intake,
- ERAS

FullText(HTML)

References(32)

References

[1]	左芦根, 张震, 王炼, 等. 腹腔镜胃癌根治术后早期肠内营养对术后康复和炎症反应的影响[J]. 肠外与肠内营养, 2023, 30(5): 287-291. doi: 10.16151/j.1007-810x.2023.05.006
[2]	吕文静, 胡玉娜. 基于目标导向的临床护理路径干预对胃癌术后患者实施早期肠内营养效果的影响[J]. 肿瘤基础与临床, 2025, 38(2): 297-300. doi: 10.3969/j.issn.1673-5412.2025.02.042
[3]	费超男, 段培蓓, 杨玲, 等. 胃癌患者围手术期营养管理的最佳证据总结[J]. 中华护理杂志, 2022, 57(19): 2345-2352. doi: 10.3761/j.issn.0254-1769.2022.19.006
[4]	曾颖, 陈姝妤, 谢金懿, 等. 基于Fitch理论的营养管理健康教育方案在胃癌术后病人出院准备度中的应用[J]. 护理研究, 2024, 38(24): 4392-4398. doi: 10.12102/j.issn.1009-6493.2024.24.010
[5]	Wobith M, Weimann A. Postoperative nutrition management: Who needs what[J]. Visc Med, 2022, 38(5): 354-362. doi: 10.1159/000526665
[6]	刘玲, 陈英, 喻红. 基于快速康复外科的全程营养管理模式在食管癌病人围术期的应用[J]. 护理研究, 2022, 36(3): 490-494. doi: 10.12102/j.issn.1009-6493.2022.03.022
[7]	Guo C H, Zhong J D, Jin X L, et al. Optimal time to initiate early oral feeding in postoperative patients with upper gastrointestinal malignancy: A network meta-analysis[J]. Int J Nurs Stud, 2024, 151: 104680. doi: 10.1016/j.ijnurstu.2023.104680
[8]	宗小燕, 李红燕, 韩小云, 等. 胃癌患者围手术期口服营养补充管理的最佳证据总结[J]. 中华护理杂志, 2025, 60(3): 355-363. doi: 10.3761/j.issn.0254-1769.2025.03.014
[9]	Fiorindi C, Raoul P, Moretto V, et al. Post-surgical diets in the ERAS protocol: D-ERAS scoping review[J]. Eur J Clin Nutr, 2026, 80(3): 233-247. doi: 10.1038/s41430-025-01692-0
[10]	尤小云, 唐宝玉. 目标管理导向的护理路径对放化疗患者口服营养补充依从性及营养指标的影响[C]// 第十七届全国营养科学大会, 中国北京, 2025: 1.
[11]	Locke E A, Latham G P. Building a practically useful theory of goal setting and task motivation: A 35-year odyssey[J]. Am Psychol, 2002, 57(9): 705-717. doi: 10.1037/0003-066X.57.9.705
[12]	臧潞, 马君俊, 郑民华. 腹腔镜胃癌手术的争议与共识[J]. 中国实用外科杂志, 2018, 38(2): 163-166. doi: 10.19538/j.cjps.issn1005-2208.2018.02.10
[13]	Muscaritoli M, Arends J, Bachmann P, et al. ESPEN practical guideline: Clinical Nutrition in cancer[J]. Clin Nutr, 2021, 40(5): 2898-2913. doi: 10.1016/j.clnu.2021.02.005
[14]	中国抗癌协会肿瘤营养专业委员会. 口服营养补充的指南更新[J]. 肿瘤代谢与营养电子杂志, 2023, 10(1): 64-68. doi: 10.16689/j.cnki.cn11-9349/r.2023.01.010
[15]	Hsu P I, Chuah S K, Lin J T, et al. Taiwan nutritional consensus consensus on the nutrition management for gastric cancer patients receiving gastrectomy[J]. J Formos Med Assoc, 2021, 120(1): 25-33. doi: 10.1016/j.jfma.2019.11.014
[16]	中国腹腔镜胃肠外科研究组(CLASS研究组), 中华医学会外科学分会腹腔镜与内镜外科学组, 中华医学会外科学分会胃肠外科学组. 腹腔镜胃癌手术患者使用口服营养补充的专家共识(2020版)[J]. 中华胃肠外科杂志, 2020, 23(7): 623-628. doi: 10.3760/cma.j.cn.441530-20200604-00342
[17]	游姗, 周慧, 李玉静, 等. 胃癌胃切除术后病人早期经口进食的最佳证据总结[J]. 循证护理, 2022, 8(11): 1449-1454. doi: 10.12102/j.issn.2095-8668.2022.11.006
[18]	姚瑶, 汪洁, 赵海峰, 等. 胃癌术后患者早期肠内营养支持的最佳证据总结[J]. 中华现代护理杂志, 2022, 28(14): 1869-1875. doi: 10.3760/cma.j.cn115682-20210822-03748
[19]	Mohajeri L, Daghayeghi R, Rostami N, et al. Early oral feeding after laparoscopic total gastrectomy in gastric cancer patients: A meta-analysis of randomized controlled trials and cohort studies[J]. BMC Gastroenterol, 2025, 25(1): 709. doi: 10.1186/s12876-025-04283-2
[20]	Canzan F, Longhini J, Caliaro A, et al. The effect of early oral postoperative feeding on the recovery of intestinal motility after gastrointestinal surgery: A systematic review and meta-analysis of randomized clinical trials[J]. Front Nutr, 2024, 11: 1369141. doi: 10.3389/fnut.2024.1369141
[21]	Xu D, Li J, Liu J, et al. An updated systematic review and meta-analysis of the efficacy and safety of early oral feeding vs. traditional oral feeding after gastric cancer surgery[J]. Front Oncol, 2024, 14: 1390065. doi: 10.3389/fonc.2024.1390065
[22]	. 《中国食物成分表》标准版第6版第一二册出版[J]. 营养学报, 2019, (5): 426.
[23]	Gomes F, Schuetz P, Bounoure L, et al. ESPEN guidelines on nutritional support for polymorbid internal medicine patients[J]. Clin Nutr, 2018, 37(1): 336-353. doi: 10.1016/j.clnu.2017.06.025
[24]	陈伟, 蒋朱明, 张永梅, 等. 欧洲营养不良风险调查方法在中国住院患者的临床可行性研究[J]. 中国临床营养杂志, 2005(3): 137-141.
[25]	刘家欢, 韩雨, 杨洋, 等. “H2h”营养管理模式对胃癌根治术后病人营养状况和生活质量的影响[J]. 肠外与肠内营养, 2022, 29(2): 116-120. doi: 10.16151/j.1007-810x.2022.02.011
[26]	汪新有, 翁延宏, 陈伟. 胃癌根治术后早期肠内营养的应用探讨[J]. 肠外与肠内营养, 2021, 28(4): 216-219. doi: 10.16151/j.1007-810x.2021.04.006
[27]	刘凯, 王文生, 肖卫东. 胃外科与营养代谢[J]. 临床外科杂志, 2025, 33(12): 1246-1249. doi: 10.3969/j.issn.1005-6483.20251104
[28]	吕家华, 郑璇, 刘洁, 等. 肿瘤患者营养疗法临床指南[J]. 中国科学: 生命科学, 2026, 56(2): 366-377.
[29]	张晓芬, 李艳, 冯丽娜, 等. 消化道肿瘤化疗患者营养管理的证据总结[J]. 护士进修杂志, 2024, 39(23): 2555-2562. doi: 10.16821/j.cnki.hsjx.2024.23.015
[30]	戴晓萍, 罗楚, 戴家伟. 基于循证的多学科合作快速康复外科护理方案用于腹部肿瘤手术患者的效果探讨[J]. 中外医药研究, 2024, 3(26): 99-101. doi: 10.3969/j.issn.2096-6229.2024.26.033
[31]	寇卫政, 王方, 唐灿伟, 等. 基于Logistic回归的胃癌患者术后并发症风险列线图预测模型[J]. 中国卫生统计, 2026, 43(3): 430-434. doi: 10.11783/j.issn.1002-3674.2026.03.021
[32]	Xiao Y, Ren B C, Zhang T, et al. Factors influencing postoperative complications in patients with gastric cancer: A retrospective study[J]. World J Gastrointest Surg, 2025, 17(5): 117-125. doi: 10.4240/wjgs.v17.i5.101047

Relative Articles(20)

Relative Articles

[1]	Haiwei WANG, Xiaohui ZHANG, Yunxiao TIAN, Shiqian WU. Mechanism of TPI-1 in Promoting the Proliferation and Invasion of Gastric Cancer Cells through Glycolytic Reprogramming. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20260204
[2]	Fusen XUE, Dawei CHEN, Jianghua SUN. Expression and Prognostic Value of miR-145-5p and FSCN1 in Gastric Cancer Tissues. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250913
[3]	Xiaoxiao FAN, Xuan ZENG, Pingping ZHOU, Xi LIU, Feifei ZHU, Yanji LUO, Yi WU. Relationship between the Platelet Autophagy-related Factor Expression and Peritoneal Metastasis of Gastric Cancer. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250715
[4]	Zhi XIE, Lang YANG, Xiaolong ZHANG. Explorations of the Clinical Pathology and Prognosis of Gastric Cancer Based on Systemic Immune Inflammation Index and Ferritin Expression. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20250915
[5]	Xiaoji LI, Xuefang YANG, Qian LIU, Chongxiang HE, Yong YANG, Guorong LI. Analysis of Serum G-17 and PG Levels in Ethnic Minority Patients with Gastric Cancer in Lijiang Area. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230429
[6]	Jiadai TANG, Jing YANG, Hongli SONG, Jiaojiao CHEN, Zhonghui MIAO, Lin XIE. Correlation of Metastatic and Prognostic Factors in 318 Cases of Primary Gastric Cancer. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230218
[7]	Huiqiong HE, Mengmei ZHANG, Ying YAN, Jing Lei, Yaying YANG, Kaipeng XIE. Diagnostic Value of MSCT Combined With MRI in T Staging of Gastric Cancer. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20230227
[8]	Zhenhuan MA, Zhen LI, Xianglin ZHOU, Guojian LI, Guokai YANG, Jia WAN, Lingjuan DU, Yong YANG. Iodine-125 Seed Inhibits the Proliferation and Invasion of Gastric Cancer Cells by Regulating MicroRNA-193b-5p Expression. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20220120
[9]	Hongyun LIAO, Yali ZHOU, Hongyun GONG, Yiqun DUAN, Qiong LI, Siyu CHEN, Hong XU, Yixian YU. Effect of Enhanced Recovery after Surgery Strategy on Stress Factors and Postoperative Rehabilitation of Patients with Ovarian cystectomy under Single-Port Surgery. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20220713
[10]	Jia-dai TANG, Lin XIE, Hong-li SONG, Jiao-jiao CHEN. Correlation between Metabolic Syndrome and the Occurrence and Development of Gastric Cancer. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20211130
[11]	Du Di , Ma Hui Fang , Qiao Jing Jing , Bai Yan , Xu Xiao Yan , Du Jing Jing , Zhao Nan Nan . . Journal of Kunming Medical University,
[12]	Jing YANG, Shu-xian WANG, Zhu ZHOU. Effect of Aerobic Exercise and Nutritional Management in Maintenance Hemodialysis Patients with Malnutrition. Journal of Kunming Medical University, doi: 10.12259/j.issn.2095-610X.S20201123
[13]	Yang Shu Di , Zhong Yu Li , Liu Ling , Tian Xin . . Journal of Kunming Medical University,
[14]	Zou Si Si , Song Xiao Yan , Deng Fei , Xu Ji Zong . . Journal of Kunming Medical University,
[15]	Tian Mei Li , Deng Jiang , Yao Kai Bo , Yao Wan Xia . . Journal of Kunming Medical University,
[16]	Liu Ling , Li Cui Lian , Xi Min , Bai Qiang , Hu Hao , Zhu Shuang Yan . Application of Enhanced Recovery after Surgery in the Infants with Congenital Duodenal Obstruction. Journal of Kunming Medical University,
[17]	Lei Hai Feng . . Journal of Kunming Medical University,
[18]	Zhou Ya Ni . . Journal of Kunming Medical University,
[19]	Song Ji . . Journal of Kunming Medical University,
[20]	. Expression and Clinical Significance of XAGE-1 Gene in Gastric Cancer. Journal of Kunming Medical University,