Purpose: Laparoscopic fundoplication is widely performed for gastroesophageal reflux disease in children with neurological impairment, but postoperative nutritional management may be difficult due to delayed gastric emptying. Therefore, we retrospectively examined the usefulness of a naso-jejunal feeding catheter (NJC) in postoperative management.

Methods: Patients with neurological impairment who underwent laparoscopic fundoplication at our hospital between 2008 and 2018 were divided into two groups based on the presence or absence of use of a NJC. Patient characteristics, nutritional status, postoperative course, and complications were compared in these groups.

Results: Laparoscopic fundoplication was performed with a NJC in 27 patients and without a NJC in 13 patients. The NJC group had a significantly earlier start of enteral feeding (1.0 ± 0.4 vs. 2.7 ± 2.6 days, p = 0.002) and earlier establishment of full enteral feeding (6.1 ± 2.1 vs. 12 ± 6.5 days, p = 0.0002). The rate of perioperative complications was also significantly lower in the NJC group (5/27 (18.5%) vs. 7/13 (53.8%), p = 0.03).

Conclusions: NJC placement in patients with neurological impairment who underwent laparoscopic fundoplication resulted in an earlier start of enteral feeding, earlier establishment of full enteral feeding, and reduction of postoperative complications.

Aim: The purpose of the study was to examine the incidence of anemia and the nutrient sufficiency associated with anemia one year after gastrectomy for patients with gastric cancer.

Subjects and Methods: The subjects were 100 patients who underwent gastrectomy for gastric cancer at our hospital from December 2016 to April 2020 and had a follow-up examination one year later. Anemia status and iron, vitamin B12, zinc, and folic acid levels and the effects of food passing through the duodenum were compared for subjects who underwent total or remnant gastrectomy.

Results: Patients who underwent total gastrectomy had low hemoglobin, poor nutrition, and low serum iron, zinc, and vitamin B12 levels. Similar results and a higher red blood cell distribution width (RDW) were obtained in patients who underwent duodenum bypass reconstruction. Cases with low ferritin and vitamin B12 had microcytic anemia, hypopigmentation, and a high RDW. Serum zinc and iron levels were weakly positively correlated, but zinc and ferritin levels were not correlated.

Conclusion: Many anemia-related nutrient deficiencies were present at one year after gastrectomy for gastric cancer. This situation needs to be kept in mind in diagnosis and management of this disease.

Purpose: The purpose of this study was to evaluate the effects and challenges of a protocol for early initiation of enteral nutrition in management of patients with acute stroke.

Subjects and Methods: The subjects were 47 patients with stroke who began enteral nutrition before (n = 22) and after (n = 25) the protocol was introduced. The number of fasting days, defecation status, length of hospital stay, rate of transition to oral absorption, modified Rankin Scale (mRS), Glasgow Coma Scale (GCS) at admission, and rate of Geriatric Nutritional Risk Index (GNRI) reduction were examined retrospectively.

Results: After introduction of the protocol, the number of fasting days and the hospital stay decreased and there were improvements in defecation status, transition rate to oral intake, and mRS, but no change in the GNRI reduction rate. With the new protocol, 68% of patients had less than Total Energy Expenditure (TEE) and 71% of these patients had oral intake.

Conclusion: The introduction of the new protocol standardized enteral nutrition management, reduced the number of fasting days, and improved defecation status and the transition to oral intake. However, TEE tended to be insufficient in the transition period to oral intake, which suggests the need for active enteral nutrition and comprehensive individualized nutritional management.