In the past， patients had to be placed nasogastric tube and kept fasting until 5 to 7 days after gastrectomy. And then， liquid diet was started after confirming no signs of leakage by esophagogastrogram， and gradually stepped-up to soft diet. Early diet was avoided because it is believed to increase the postoperative complications. However， from the late 1990s， it had been reported that patient recovery was improved by early oral feeding， early mobilization and sufficient pain control using epidural analgesia in colorectal cancer. These programs were further refined and integrated as so-called enhanced recovery after surgery (ERAS)， and these programs rapidly prevailed all over the world in combination with the wide spread of laparoscopic minimal invasive surgery. However， introduction of early oral feeding in gastric surgery had been very limited compared with colorectal surgery possibly due to the fear for increasing postoperative complications in related with upper gastrointestinal anastomosis. 

 

Several randomized controlled trials (RCTs) revealed that ERAS pathways reduced the length of hospital stay and morbidity after surgery without compromising patient safety. However， there was significant heterogeneity in non-ERAS management of control subjects and most trials included fewer than 50 patients in each group from single institute. Thus， the evidence supporting use of the ERAS protocol for gastric cancer surgery was considered still insufficient. To evaluate the comprehensive meaning of ERAS program including early oral feeding， multi-institutional prospective RCT with large sample size is essential. Precise inclusion and exclusion criteria for program especially in age and co-morbidity should also be indicated in the future.