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Review
. 2022 Mar;34(3):451-458.
doi: 10.1111/den.14140. Epub 2021 Oct 13.

Early versus delayed feeding after therapeutic endoscopic procedures: Meta-analysis of randomized controlled trials

Sheau Wen Kan  1 , Ting-Yun Huang  1   2 , Hon-Ping Ma  1   3 , Ming Zhe Tay  4 , Ka-Wai Tam  5   6   7 , Tung-Yao Tsai  1   2
Affiliations
Review

Early versus delayed feeding after therapeutic endoscopic procedures: Meta-analysis of randomized controlled trials

Sheau Wen Kan et al. Dig Endosc. 2022 Mar.

Abstract

Introduction: Early feeding was previously considered to increase the risk of postprocedural bleeding. However, many trials have demonstrated the benefits of early feeding after therapeutic endoscopic procedures. We conducted a meta-analysis of randomized controlled trials to evaluate the safety and outcomes between early feeding and delayed feeding after therapeutic endoscopic procedures.

Methods: Medline (PubMed), Embase, Google Scholar, the Cochrane Library, and clinicaltrials.gov were searched to identify randomized controlled trials that met our inclusion criteria. The pooled data for the mortality rate, postprocedural bleeding rate, and length of hospital stay were analyzed.

Results: A total of seven trials consisting of 717 patients were reviewed. These seven trials examined various therapeutic endoscopic procedures. Three trials included patients undergoing endoscopic hemostasis for upper gastrointestinal bleeding, two included patients undergoing esophageal variceal ligation, and two included patients with gastric neoplasm treated with endoscopic submucosal dissection. Although no significant differences were observed in the postprocedural bleeding rate or the mortality rate between patients who received early feeding and those who received delayed feeding, early feeding resulted in shorter hospital stays (weighted mean difference -1.04, 95% confidence interval -1.45 to 0.63).

Conclusion: Early feeding appears to be a safe management method for patients undergoing therapeutic endoscopic procedures. Therefore, we recommend early feeding for these patients.

Keywords: delayed feeding; early enteral nutrition; early feeding; endoscopic procedures; endoscopic submucosal dissection.

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References

    1. Karstensen JG, Ebigbo A, Bhat P et al. Endoscopic treatment of variceal upper gastrointestinal bleeding: European Society of Gastrointestinal Endoscopy (ESGE) Cascade Guideline. Endosc Int Open 2020; 8: E990-7.
    1. Mujtaba S, Chawla S, Massaad JF. Diagnosis and management of non-variceal gastrointestinal hemorrhage: A review of current guidelines and future perspectives. J Clin Med 2020; 9: 402.
    1. Hébuterne X, Vanbiervliet G. Feeding the patients with upper gastrointestinal bleeding. Curr Opin Clin Nutr Metab Care 2011; 14: 197-201.
    1. Murata A, Matsuda S. How long should patients fast after endoscopic hemostasis for non-variceal upper gastrointestinal bleeding? Findings from a national administrative database. Asian Pac J Dis Manage 2011; 5: 5-11.
    1. Lin HJ, Perng CL, Lee FY, Lee CH, Lee SD. Clinical courses and predictors for rebleeding in patients with peptic ulcers and non-bleeding visible vessels: A prospective study. Gut 1994; 35: 1389-93.

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