Table 1 .

Modified ERAS^® protocol (MEP) in gastric surgery

Operative day	−1	0	+1	+2	+3	+4	+5	+6	+7
Oral intake	Normal diet until midnight	Oral hydration solution (OS-1®) 3 h before surgery		Drink water and oral nutrition supplement (Ensure Liquid)	Liquid diet (3 steps up to soft diet every 2 days)
Bowel preparation	1 g magnesium oxide and New Lecicarbon® suppository
		Combination of epidural analgesia (TH7-11) and general anesthesia during surgery
Anesthesia and Analgesics		Continuous thoracic epidural infusion of analgesics after surgery	→	Removing epidural catheter
		Nonsteroidal anti-inflammatory drug intravenously after surgery twice daily	→	Acetoaminophen three times a day orally	→	→	→
Drain and NGT		No drain in distal gastrectomy, one or two drains in total gastrectomy NGT was removed immediately after surgery		Removing drain(s)
ADL			Encourage to sit out of bed for more than 6 h	Encourage to walk the length of the ward	→	→	→	→	→
Antithrombopro phylaxis			None	Subcutaneous injection of antithrombotic agent (enoxaparin sodium or fondaparinux)	→	→	None	→	→
X-ray and blood exam.		○	○						○ (Check discharge criteria)