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Review
. 2022 Mar 22:9:807811.
doi: 10.3389/fsurg.2022.807811. eCollection 2022.

Impact of Early Oral Feeding on Nasogastric Tube Reinsertion After Elective Colorectal Surgery: A Systematic Review and Meta-Analysis

Yan Wang  1 , Yanji Zhang  2 , Xing Hu  1 , Hui Wu  1 , Shan Liang  1 , Jing Jin  1 , Yunjun Wu  1 , Yao Cen  1 , Zairong Wei  2 , Dali Wang  3
Affiliations
Review

Impact of Early Oral Feeding on Nasogastric Tube Reinsertion After Elective Colorectal Surgery: A Systematic Review and Meta-Analysis

Yan Wang et al. Front Surg. .

Abstract

Background: Colorectal cancer is a common malignant tumor appearing in the gastrointestinal tract. Surgical resection is recognized as the best means to improve patient survival. However, it is controversial whether early oral feeding (EOF) after elective colorectal resection demonstrates safety and efficacy in concerned clinical outcomes.

Methods: We searched PubMed, Embase, Cochrane Library, and CNKI from inception to September 2021. Two authors independently screened the retrieved records and extracted data. EOF was defined as feeding within 24 h after surgery, while traditional oral feeding (TOF) was defined as feeding that started after the gastrointestinal flatus or ileus was resolved. The primary outcome was nasogastric tube insertion, and the secondary outcomes were the length of hospital stay and total complications. Categorical data were combined using odds ratio (OR), and continuous data were combined using mean difference (MD).

Results: We screened 10 studies from 34 records after full-text reading, with 1,199 patients included in the analysis. Nasogastric tube reinsertion (OR 1.69; 95% CI 1.08 to 2.64, p=0.02) was more frequent in the EOF group, and older ages (>60 years) were associated with higher risk of nasogastric tube reinsertion (OR 2.05; 95% CI 1.05 to 3.99, p = 0.04). Reduced length of hospital stay (MD -1.76; 95% CI -2.32 to -1.21; p < 0.01) and the rate of total complications (OR 0.49; 95% CI 0.37 to 0.65, p < 0.01) were observed in EOF compared with TOF.

Conclusions: EOF was safe and effective for patients undergoing elective colorectal surgery, but the higher rate of nasogastric tube reinsertion compared with TOF should not be ignored.

Keywords: early oral feeding; elective colorectal surgery; meta-analysis; nasogastric tube reinsertion; systematic review.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of study selection.
Figure 2
Figure 2
Forest plots of nasogastric reinsertion. All of the included studies were synthesized.
Figure 3
Figure 3
Forest plots of nasogastric reinsertion. (A) Patients over 60 years. (B) Patients <60 years.
Figure 4
Figure 4
Forest plots of length of hospital stay.
Figure 5
Figure 5
Forest plots of total complications.
Figure 6
Figure 6
Forest plots of total complications. (A) Major complications. (B) Minor complications.
See this image and copyright information in PMC

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