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Review
. 2022 Apr 29;22(1):167.
doi: 10.1186/s12935-022-02586-y.

Early versus delay oral feeding for patients after upper gastrointestinal surgery: a systematic review and meta-analysis of randomized controlled trials

Huachu Deng  1 , Baibei Li  2 , Xingan Qin  3
Affiliations
Review

Early versus delay oral feeding for patients after upper gastrointestinal surgery: a systematic review and meta-analysis of randomized controlled trials

Huachu Deng et al. Cancer Cell Int. .

Abstract

Purpose: To evaluate the efficacy and safety of early oral feeding (EOF) in patients after upper gastrointestinal surgery through meta-analysis of randomized controlled trials (RCTs).

Methods: We analyzed the endpoints of patients including the length of stay (LOS), time of first exhaust, anastomotic leakage and pneumonia from included studies. And we retrieved RCTs from medical literature databases. Weighted mean difference (WMD), risk ratios (RR) and 95% confidence intervals (CI) were calculated to compare the endpoints.

Results: In total, we retrieved 12 articles (13 trial comparisons) which contained 1771 patients. 887 patients (50.1%) were randomized to EOF group whereas 884 patients (49.9%) were randomized to delay oral feeding group. The result showed that compared with the delay oral feeding group, EOF after upper gastrointestinal surgery significantly shorten the LOS [WMD = - 1.30, 95% CI - 1.79 to - 0.80, I2 = 0.0%] and time of first exhaust [WMD = - 0.39, 95% CI - 0.58 to - 0.20, I2 = 62.1%]. EOF also reduced the risk of pneumonia (RR: 0.74, 95% CI 0.55 to 0.99, I2 = 0.0%). There is no significant difference in the risk of anastomotic leak, anastomotic bleeding, abdominal abscess, reoperation, readmission and mortality.

Conclusions: Overall, compared with the traditional oral feeding, EOF could shorten the LOS and time of first exhaust without increasing complications after upper gastrointestinal surgery.

Keywords: Early oral feeding; Meta-analysis; Upper gastrointestinal surgery.

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Conflict of interest statement

The authors declare that there are no conflicts of interest regarding the publication of this paper.

Figures

Fig. 1
Fig. 1
Flow diagram of included studies selection
Fig. 2
Fig. 2
Forest plot of the LOS in EOF group and the DOF group. WMD weighted mean difference, LOS length of stay, EOF early oral feeding, DOF delay oral feeding
Fig. 3
Fig. 3
Forest plot of the time of first exhaust in EOF group and the DOF group. WMD weighted mean difference, EOF early oral feeding, DOF delay oral feeding
Fig. 4
Fig. 4
Subgroup analysis of time of first exhaust in EOF group and the DOF group. WMD weighted mean difference, EOF early oral feeding, DOF delay oral feeding
Fig. 5
Fig. 5
Forest plot of the risk of pneumonia in EOF group and DOF group. RR risk ratio, EOF early oral feeding, DOF delay oral feeding
Fig. 6
Fig. 6
Forest plot of the risk of anastomotic leak in EOF group and DOF group. RR risk ratio, EOF early oral feeding, DOF delay oral feeding
Fig. 7
Fig. 7
Forest plot of the risk of anastomotic bleeding in EOF group and the DOF group. RR risk ratio, EOF early oral feeding, DOF delay oral feeding
Fig. 8
Fig. 8
Forest plot of the risk of abdominal abscess in EOF group and the DOF group. RR risk ratio, EOF early oral feeding, DOF delay oral feeding
Fig. 9
Fig. 9
Forest plot of the accidence of reoperation in EOF group and the DOF group. RR risk ratio, EOF early oral feeding, DOF delay oral feeding
Fig. 10
Fig. 10
Forest plot of the accidence of readmission in EOF group and the DOF group. RR risk ratio, EOF early oral feeding, DOF delay oral feeding
Fig. 11
Fig. 11
Forest plot of the mortality in EOF group and the DOF group. RR risk ratio, EOF early oral feeding, DOF delay oral feeding
Fig. 12
Fig. 12
Funnel plot of pneumonia in EOF group and DOF group. RR risk ratio, EOF early oral feeding, DOF delay oral feeding
Fig. 13
Fig. 13
Funnel plot of anastomotic leak in EOF group and DOF group. RR risk ratio, EOF early oral feeding, DOF delay oral feeding
Fig. 14
Fig. 14
Sensitivity analysis of time of first exhaust in the EOF group and DOF group. RR risk ratio, EOF early oral feeding, DOF delay oral feeding
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