Meta-analysis Of Postoperative Of Esophageal Cancer With Enteral Nutrition And Parenteral Nutrition Support

Objective:By incorporating randomized controlled trial data into meta-analysis,To compare the pros and cons of two different nutritional support methods for postoperative esophageal cancer,And explain the possible causes of this phenomenon from the physiological mechanism,So find a better postoperative nutritional support.methods:Search Chinese database: HowNet,Wanfang,English database: pubmed,embase,cochrane,In the literature of randomized controlled trials that meet the inclusion criteria,select high quality literature,Meta-analysis of the general condition and complications of postoperative patients in each group of patients was performed.Result:A total of 14 articles were selected in this paper,including 12 Chinese articles and 2 English articles.A total of 1221 patients were included,of which 620 patients received postoperative enteral nutrition and 601 received postoperative parenteral nutrition.(1).Postoperative complications of anastomotic leakage in line with literature selected 7 patients with 687 cases,EN group 337 cases;PN group 350 cases.The index I2 index of the two groups was 0%,no significant heterogeneity,and feasible meta-analysis.Meta-analysis results: the combined odds ratio(OR combined)was 0.43(95% CI 0.21-0.88),Z value = 2.31(P=0.02<0.05),the difference was statistically significant,the funnel plot was symmetrical,and there was no publication bias.(2).Postoperative pulmonary complications in line with literature selected 11 patients with 999 cases,EN group 498 cases;PN group 501 cases.The index I2 index of the two groups was 0%,no significant heterogeneity,and feasible meta-analysis.Meta-analysis results: the combined odds ratio(OR combined)was 0.35(95% CI 0.20-0.60),Z value = 3.78(P=0.0002<0.05),the difference was statistically significant,the funnel plot was symmetrical,and there was no publication bias.(3).Gastrointestinal reaction complications in line with literature selected 5 patients with 362 cases,EN group 192 cases;PN group 170 cases.The index I2 index of the two groups was 0%,no significant heterogeneity,and feasible meta-analysis.Meta analysis results: the combined odds ratio(OR combined)was 1.16(95% CI 0.69-1.95),Z value = 0.55(P=0.58>0.05),the difference was not statistically significant,the funnel plot was symmetrical,no publication bias.(4).Incision infection complications in line with literature selected 8 patients with 771 cases,EN group 414 cases;PN group 357 cases.The index I2 index of the two groups was 0%,no significant heterogeneity,and feasible meta-analysis.Meta-analysis results: the combined odds ratio(OR combined)was 0.65(95% CI 0.36-1.08),and the Z value = 1.68(P=0.09>0.05).The difference was not statistically significant.The funnel plot was bilaterally symmetric and had no publication bias.(5).First exhaust time in line with literature selected 8 patients with 546 cases,EN group 285 cases;PN group 261 cases.The index I2 index of the two groups was 98%,and there was heterogeneity between the groups.The meta-analysis results showed that the MD value was-22.84(95% CI was-32.77-12.91)and the Z value was 4.51(P<0.00001<0.05).The difference is statistically significant.(6).Hospital stay in line with literature selected 6 patients with 529 cases,EN group 261 cases;PN group 268 cases.The index I2 index of the two groups was 85%,and there was significant heterogeneity between the groups.The meta-analysis results showed that the MD value was-2.59(95% CI was-3.15--2.04)and the Z value was 9.15(P<0.00001<0.05).The difference is statistically significant.Conclusion:Postoperative esophageal cancer Patients should prefer enteral nutrition as a nutritional support.