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The protocol could be modified by adding:
– Nutritional supplement, preferably immunonutrition 7 days before and 5 days after the intervention.
– Consider minimally invasive surgery (MIS) in selected cases for both early and locally advanced gastric cancers (not recommended for T4B or N2 bulky tumors), based on surgeon experience performing laparoscopic/robotic foregut surgery and lymphadenectomy for gastric cancer.
– Oral administration of 200-400 ml of a drink containing 25-50 g of carbohydrates up to two hours before the intervention, if there is no contraindication (in case of diabetes, administer together with antidiabetic medication).
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