Comparison Of Different Nutritional Support Mode After Esophagectomy:A Meta-analysis

Objective:To compare the clinical efficacy of different nutritional mode and its impact on the outcome of the patients.Methods:We searched the electronic bibliographic databases,including PubMed,the Cochrane Library,Web of science,CBM,CNKI,VIP and Wanfang data to January 2020.Two reviewers independently assemble the randomized controlled trials(RCTs),cohort studies and case control studies according to the inclusion and exclusion criteria.Data were extracted and evaluated independently then The RevMan 5.3 software was used for meta-analysis on included studies.Results:fifteen trials were included,involving four randomized controlled trials(RCTs),three cohort studies and eight case-control studies.The result of Meta-analysis indicated:(1)There were no significant differences on the occurence of anastomotic leak[OR=1.31,95%CI(0.98,1.75),P=0.07 ],pulmonary complications[OR= 0.79,95%CI(0.54,1.14),P=0.20 ],thirty-days mortality [OR= 1.00,95%CI(0.41,2.42),P=0.99 ] and other complications rate[OR= 0.84,95%CI(0.50,3.13),P=0.16 ] between the patients who received early oral feeding(EOF)and conventional oral feeding(COF)patients after esophagectomy;(2)Compared with the COF patients,time to first flatus was significantly shorter in the EOF group[OR=-1.29,95%CI(-1.69,-0.88),P<0.00001 ];(3)Median lengths of postoperative stay was shorter in the EOF patients[OR=-2.10,95%CI(-3.32,-0.88),P=0.0008 ]versus COF after esophagectomy.Conclusion:Early oral feeding after esophageal cancer does not increase the risk of postoperative complications,and can promote the recovery of gastrointestinal function and shorten length of hospital stay,and worthy to be popularized clinically.