School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia.
Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
J Hum Nutr Diet. 2022 Feb;35(1):33-48. doi: 10.1111/jhn.12930. Epub 2021 Jul 12.
Nutrition post major upper gastrointestinal (UGI) cancer surgery is a significant consideration known to affect postoperative recovery and the ability to tolerate adjuvant treatment. This systematic review assessed the effect of early oral feeding (EOF), compared to traditional timing of oral feeding, following major surgery for UGI cancer on postoperative complications, postoperative length of hospital stay (LOS), nutritional status and quality of life (QOL). The literature was searched up to March 9th 2020 using CINHAL, PubMed, MEDLINE, Embase, Scopus and Web of Science databases. Quality assessment was completed using the Academy of Nutrition and Dietetics quality criteria checklist. Fifteen articles were included, consisting of seven randomised controlled trials, six cohort studies and two non-randomised trials, with a total of 2517 participants. The type and timing of EOF varied considerably across studies with limited reporting of energy and protein intakes from oral or enteral feeding. Fourteen studies assessed postoperative complications of which 13 reported no difference between EOF and standard care. Fourteen studies assessed postoperative LOS and of these, 13 reported a reduced length of stay in the EOF group. Four of 15 studies assessing nutritional status found no difference between groups. Three of 15 studies assessed QOL with inconsistent findings. This review found EOF reduced postoperative LOS and did not increase postoperative complications. However, the optimal timing for the introduction of EOF could not be established. Furthermore, the type of EOF varied considerably making comparison across studies challenging and demonstrates a need for internationally standardised definitions.
上消化道（UGI）癌症手术后的营养支持是一个重要的考虑因素，已知其会影响术后恢复和对辅助治疗的耐受能力。本系统评价评估了与传统的口服喂养时间相比，在上消化道癌症手术后早期口服喂养（EOF）对术后并发症、术后住院时间（LOS）、营养状况和生活质量（QOL）的影响。文献检索截至 2020 年 3 月 9 日，使用了 CINHAL、PubMed、MEDLINE、Embase、Scopus 和 Web of Science 数据库。使用营养与饮食学会质量标准检查表完成了质量评估。共纳入了 15 篇文章，包括 7 项随机对照试验、6 项队列研究和 2 项非随机试验，共有 2517 名参与者。研究之间 EOF 的类型和时间差异很大，报告的口服或肠内喂养的能量和蛋白质摄入量有限。14 项研究评估了术后并发症，其中 13 项报告 EOF 与标准护理之间无差异。14 项研究评估了术后 LOS，其中 13 项报告 EOF 组的住院时间缩短。15 项评估营养状况的研究中有 4 项发现两组之间无差异。15 项研究中有 3 项评估了 QOL，结果不一致。本综述发现 EOF 可缩短术后 LOS，且不会增加术后并发症。然而，无法确定 EOF 引入的最佳时机。此外，EOF 的类型差异很大，使得在研究之间进行比较具有挑战性，这表明需要制定国际标准化的定义。
