Hao Tao, Liu Qian, Lv Xin, Qiu Jun, Zhang Hao-Ran, Jiang Hai-Ping
The First Affiliated Hospital of Jinan University, Jinan University, Guangzhou 510632, Guangdong Province, China.
Department of Cardiology, The Affiliated Hospital of Binzhou Medical College, Binzhou 256600, Shandong Province, China.
World J Gastrointest Surg. 2021 Jul 27;13(7):717-733. doi: 10.4240/wjgs.v13.i7.717.
Early oral feeding (EOF) is an important measure for early recovery of patients with gastrointestinal tumors after surgery, which has emerged as a safe and effective postoperative strategy for improving clinical outcomes.
To determine the safety and efficacy of early oral feeding in postoperative patients with upper gastrointestinal tumor.
This meta-analysis was analyzed using Review Manager version 5.3 and Stata version 14. All clinical studies that analyzed efficacy and safety of EOF for postoperative patients with upper gastrointestinal tumor were included.
Fifteen studies comprising 2100 adult patients met all the inclusion criteria. A significantly lower risk of pneumonia was presented in the EOF compared with TOF group [relative risk (RR) = 0.63, 95% confidence interval (CI): 0.44-0.89, = 0.01]. Length of hospital stay was significantly shorter in the EOF group than in the TOF group [weighted mean difference (WMD) = -1.91, 95%CI: -2.42 to -1.40; < 0.01]. Cost of hospitalization was significantly lower (WMD = -4.16, 95%CI: -5.72 to -2.61; < 0.01), and CD4 cell count and CD4/CD8 cell ratio on postoperative day 7 were significantly higher in the EOF group than in the TOF group: CD4 count (WMD = 7.17, 95%CI: 6.48-7.85; < 0.01), CD4/CD8 ratio (WMD = 0.29, 95%CI: 0.23-0.35; < 0.01). There was no significant difference in risk of anastomotic leak and total postoperative complications.
EOF as compared with TOF was associated with lower risk of pneumonia, shorter hospital length of stay, lower cost of hospitalization, and significantly improved postoperative immune function of patients.
早期经口进食（EOF）是胃肠道肿瘤患者术后早期恢复的一项重要措施，已成为改善临床结局的一种安全有效的术后策略。
确定早期经口进食在上消化道肿瘤术后患者中的安全性和有效性。
本荟萃分析使用Review Manager 5.3版和Stata 14版进行分析。纳入所有分析早期经口进食对上消化道肿瘤术后患者有效性和安全性的临床研究。
15项研究共纳入2100例成年患者，均符合所有纳入标准。与传统经口进食（TOF）组相比，早期经口进食组肺炎风险显著降低[相对危险度（RR）=0.63，95%置信区间（CI）：0.44 - 0.89，P = 0.01]。早期经口进食组住院时间显著短于传统经口进食组[加权均数差（WMD）=-1.91，95%CI：-2.42至-1.40；P < 0.01]。住院费用显著降低（WMD=-4.16，95%CI：-5.72至-2.61；P < 0.01），且术后第7天早期经口进食组CD4细胞计数和CD4/CD8细胞比值显著高于传统经口进食组：CD4计数（WMD = 7.17，95%CI：6.48 - 7.85；P < 0.01），CD4/CD8比值（WMD = 0.29，95%CI：0.23 - 0.35；P < 0.01）。吻合口漏风险和术后总并发症发生率无显著差异。
与传统经口进食相比，早期经口进食与较低的肺炎风险、较短的住院时间、较低的住院费用以及患者术后免疫功能显著改善相关。
