Department of Cardiothoracic Surgery, the First Affiliated Hospital of Guangxi Medical University, No. 6, Shuangyong Road, Nanning, 530021, China.
Support Care Cancer. 2022 Apr;30(4):3473-3483. doi: 10.1007/s00520-022-06813-0. Epub 2022 Jan 11.
Nil by mouth is considered the standard of care during the first days following esophagectomy. However, with the routine implementation of enhanced recovery after surgery, early oral intake is more likely to be the preferred mode of nutrition following esophagectomy. The present study aims to evaluate the safety and effectiveness of early oral intake following esophagectomy for esophageal cancer.
Comprehensive literature searches were conducted using PubMed, Web of Science, Embase, and Cochrane Library. Weighted mean differences (WMD) and odds ratios (OR) with 95% confidence intervals (CI) were calculated as the effect sizes for continuous and dichotomous variables, respectively.
Fourteen studies with a total of 1947 patients were included. Length of hospital stay (WMD = - 3.94, CI: - 4.98 to - 2.90; P < 0.001), the time to first flatus (WMD = - 1.13, CI: - 1.25 to - 1.01; P < 0.001) and defecation (WMD = - 1.26, CI: - 1.82 to - 0.71; P < 0.001) favored the early oral intake group. There was no statistically significant difference in mortality (OR = 1.23, CI: 0.45 to 3.36; P = 0.69). Early oral intake also did not increase the risk of pneumonia and overall postoperative complications.
Current evidence indicates early oral intake following esophagectomy seems to be safe and effective. It may be the preferred mode of nutrition following esophagectomy. However, more high-quality studies are still needed to further validate this conclusion.
在食管切除术后的最初几天，禁食被认为是标准的护理方法。然而，随着手术后强化康复的常规实施，食管切除术后早期口服摄入更有可能成为首选的营养方式。本研究旨在评估食管切除术后早期口服摄入治疗食管癌的安全性和有效性。
使用 PubMed、Web of Science、Embase 和 Cochrane Library 进行全面的文献检索。使用加权均数差（WMD）和比值比（OR）及其 95%置信区间（CI）分别计算连续和二分类变量的效应量。
纳入了 14 项研究，共 1947 例患者。住院时间（WMD=-3.94，CI：-4.98 至-2.90；P<0.001）、首次排气时间（WMD=-1.13，CI：-1.25 至-1.01；P<0.001）和首次排便时间（WMD=-1.26，CI：-1.82 至-0.71；P<0.001）均有利于早期口服摄入组。两组间死亡率无统计学差异（OR=1.23，CI：0.45 至 3.36；P=0.69）。早期口服摄入也不会增加肺炎和总体术后并发症的风险。
目前的证据表明，食管切除术后早期口服摄入似乎是安全有效的。它可能是食管切除术后首选的营养方式。然而，仍需要更多高质量的研究来进一步验证这一结论。
