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择期肠道手术后早期经口进食的耐受性及术后结局:一项系统评价与荟萃分析

Tolerance to and postoperative outcomes with early oral feeding following elective bowel surgery: a systematic review with meta-analysis.

作者信息

Mvoula Lord, Irizarry Evelyn

机构信息

Department of Surgery, NYC Health + Hospitals/Lincoln, New York City, NY, USA.

出版信息

Ann Coloproctol. 2024 Dec;40(6):538-547. doi: 10.3393/ac.2023.00472.0067. Epub 2024 Jul 31.

Abstract

PURPOSE

Advancements in gastrointestinal surgery have directed attention toward optimizing recovery, including through the use of feeding methods that reduce prolonged postoperative hospital stays, complications, and mortality, among other undesirable outcomes. This study's primary goals were to identify current peer-reviewed literature reporting the postoperative outcomes of elective bowel surgery and to evaluate the clinical evidence of patients' tolerance to oral feeding following elective bowel surgery.

METHODS

An exhaustive literature search was conducted via PubMed and Scopus. The search results were screened for potential articles, and articles were assessed for eligibility based on prespecified eligibility criteria. The data were synthesized, and the results were reported and discussed thematically.

RESULTS

The database search yielded 1,667 articles, from which 18 randomized controlled trials were chosen for inclusion in this study. This study included 874 early oral feeding (EOF) patients, 865 traditional oral feeding patients, and 91 patients whose postoperative care was unspecified. Data synthesis was done, and meta-analyses were conducted. The results showed that EOF patients required a significantly shorter time to tolerate a solid diet and had shorter hospital stays. In addition, bowel function was restored earlier in EOF groups.

CONCLUSION

The results show good tolerance to EOF, shorter hospitalizations, and faster restoration of bowel function, suggesting that EOF after elective bowel surgery is relatively safe. However, further studies with similar baseline conditions should be conducted to verify these results.

摘要

目的

胃肠外科的进展已将注意力转向优化恢复,包括通过采用减少术后长期住院时间、并发症和死亡率等不良后果的喂养方法。本研究的主要目标是识别当前经同行评审的报告择期肠道手术术后结果的文献,并评估择期肠道手术后患者对口服喂养耐受性的临床证据。

方法

通过PubMed和Scopus进行了详尽的文献检索。对检索结果筛选潜在文章,并根据预先设定的纳入标准评估文章的合格性。对数据进行综合,并按主题报告和讨论结果。

结果

数据库检索产生了1667篇文章,从中选择了18项随机对照试验纳入本研究。本研究包括874例早期口服喂养(EOF)患者、865例传统口服喂养患者和91例术后护理未明确的患者。进行了数据综合和荟萃分析。结果显示,EOF患者耐受固体饮食所需时间显著更短,住院时间也更短。此外,EOF组肠道功能恢复更早。

结论

结果表明对EOF耐受性良好、住院时间缩短且肠道功能恢复更快,这表明择期肠道手术后的EOF相对安全。然而,应进行具有相似基线条件的进一步研究以验证这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/81c2/11701455/796e3ebb241c/ac-2023-00472-0067f1.jpg

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