Impact of early enteral versus parenteral nutrition on postoperative efficacy of esophageal cancer: A systematic review and meta-analysis
- VernacularTitle:早期肠内或肠外营养对食管癌术后疗效影响的系统评价与 Meta 分析
- Author:
Xiaoqing LIU
1
;
Linchun GAO
1
;
Dong ZHOU
1
;
Quanxing LIU
1
;
Hong ZHENG
1
;
Jing LI
1
Author Information
1. Department of Thoracic Surgery, Xinqiao Hospital, Army Military Medical University, Chongqing, 400037, P.R.China
- Publication Type:Journal Article
- Keywords:
Esophageal cancer;
enteral nutrition;
complications;
systematic reviews/meta-analysis
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2020;27(11):1341-1347
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the impact of early enteral nutrition (EN) and parenteral nutrition (PN) on the postoperative efficacy of esophageal cancer through meta-analysis of relevant randomized controlled trial (RCT). Methods PubMed, Medline, EMbase, The Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP, China Biology Medicine disc (CBMdisc) were searched by computer from inception to April 2018 to identify potential RCT which assessed clinical efficacy between EN and PN for postoperative patients with esophageal cancer. According to the inclusion and exclusion criteria, two researchers independently screened and evaluated literature. Meta-analysis was performed by RevMan 5.3 software. Results A total of 30 RCT studies were selected, including 3 969 patients. Meta-analysis results showed that: there was a significant difference between EN and PN in postoperative anastomotic fistulas (I2=0%, OR=0.67, 95%CI 0.45-0.99, P=0.04), postoperative pulmonary infections (I2=0%, OR=0.42, 95%CI 0.32-0.55, P<0.000 1), postoperative albumin levels (I2=38%, MD=0.78, 95%CI 0.51-1.06, P<0.000 01), time of first anal exhaust after operation (I2=0%, MD=–23.16, 95%CI –25.16-21.16, P<0.000 01) and postoperative incision infection (I2=0%, RR=0.36, 95%CI 0.21-0.64, P=0.000 5). Conclusion Compared with PN, early EN can significantly reduce the incidence of major postoperative complications and shorten the time of first anal exhaust after surgery. In addition, EN is superior to PN in improving nutritional status, increasing weight and reducing costs and side effects.
