Sindler Dóra Lili, Mátrai Péter, Szakó Lajos, Berki Dávid, Berke Gergő, Csontos Armand, Papp Csenge, Hegyi Péter, Papp András
Department of Surgery, Clinical Center, Medical School, University of Pécs, Pécs, Hungary.
Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.
Front Surg. 2023 May 25;10:1092303. doi: 10.3389/fsurg.2023.1092303. eCollection 2023.
There were more than 1 million new cases of stomach cancer concerning oesophageal cancer, there were more than 600,000 new cases of oesophageal cancer in 2020. After a successful resection in these cases, the role of early oral feeding (EOF) was questionable, due to the possibility of fatal anastomosis leakage. It is still debated whether EOF is more advantageous compared to late oral feeding. Our study aimed to compare the effect of early postoperative oral feeding and late oral feeding after upper gastrointestinal resections due to malignancy.
Two authors performed an extensive search and selection of articles independently to identify randomized control trials (RCT) of the question of interest. Statistical analyses were performed including mean difference, odds ratio with 95% confidence intervals, statistical heterogeneity, and statistical publication bias, to identify potential significant differences. The Risk of Bias and the quality of evidence were estimated.
We identified 6 relevant RCTs, which included 703 patients. The appearance of the first gas (MD = -1.16; = 0.009), first defecation (MD = -0.91; < 0.001), and the length of hospitalization (MD = -1.92; = 0.008) favored the EOF group. Numerous binary outcomes were defined, but significant difference was not verified in the case of anastomosis insufficiency ( = 0.98), pneumonia ( = 0.88), wound infection ( = 0.48), bleeding ( = 0.52), rehospitalization ( = 0.23), rehospitalization to the intensive care unit (ICU) ( = 0.46), gastrointestinal paresis ( = 0.66), ascites ( = 0.45).
Early postoperative oral feeding, compared to late oral feeding has no risk of several possible postoperative morbidities after upper GI surgeries, but has several advantageous effects on a patient's recovery.
identifier, CRD 42022302594.
2020年，胃癌合并食管癌的新发病例超过100万，食管癌新发病例超过60万。在这些病例成功切除后，早期经口进食（EOF）的作用存在疑问，因为存在致命性吻合口漏的可能性。与延迟经口进食相比，EOF是否更具优势仍存在争议。我们的研究旨在比较因恶性肿瘤行上消化道切除术后早期经口进食和延迟经口进食的效果。
两位作者独立进行广泛的文献检索和筛选，以确定感兴趣问题的随机对照试验（RCT）。进行了统计分析，包括平均差、95%置信区间的比值比、统计异质性和统计发表偏倚，以确定潜在的显著差异。评估了偏倚风险和证据质量。
我们确定了6项相关的RCT，共纳入703例患者。首次排气（MD = -1.16；P = 0.009）、首次排便（MD = -0.91；P < 0.001）和住院时间（MD = -1.92；P = 0.008）方面，EOF组更具优势。定义了许多二元结局，但在吻合口漏（P = 0.98）、肺炎（P = 0.88）、伤口感染（P = 0.48）、出血（P = 0.52）、再次住院（P = 0.23）、入住重症监护病房（ICU）再次住院（P = 0.46）、胃肠麻痹（P = 0.66）、腹水（P = 0.45）方面未证实有显著差异。
与延迟经口进食相比，上消化道手术后早期经口进食没有增加几种可能的术后并发症风险，但对患者恢复有几个有利影响。
标识符，CRD 42022302594。
