Yinfeng Shen1, WenYin Jin. 1. Department of Surgery, Hubei Hospital of Traditional Chinese Medicine, Hubei University of Chinese Medicine, Wuhan 430061, PR China.
Abstract
PURPOSE: The aim of our study was to evaluate the safety and effectiveness of early enteral nutrition (EN) for patients after pancreatoduodenectomy (PD). METHODS: We performed a comprehensive search of abstracts in the MEDLINE database, OVID database, Springer database, the Science Citation Index, and the Cochrane Library database. Published data of randomized clinical trials (RCTs) comparing the clinically relevant outcomes of early EN and other nutritional routes for patients after PD were analyzed. The analyzed outcome variables included gastroparesis, intra-abdominal complications (gastroparesis excluded), mortality, infection, and postoperative hospital stay. The Cochrane Collaboration's RevMan 5.1 software was used for statistical analysis. RESULTS: Four RCTs published in 2000 or later were included in this meta-analysis, in which 246 patients underwent early EN and 238 patients underwent other nutritional routes following PD. In the combined results of early EN versus other nutritional routes, no significant difference could be found in gastroparesis (odds ratio (OR), 0.89; 95 % CI, 0.36-2.18; P = 0.79), intra-abdominal complications (gastroparesis excluded) (OR, 0.82; 95 % CI, 0.53-1.26; P = 0.37), mortality (OR, 0.43; 95 % CI, 0.11-1.62; P = 0.21), infection (OR, 0.55; 95 % CI, 0.29-1.07; P = 0.08), postoperative hospital stay (mean difference, -0.93; 95 % CI, -6.51 to 4.65; P = 0.74). CONCLUSIONS: Current RCTs suggests that early EN appears safe and tolerated for patients after PD, but does not show advantages in infection and postoperative hospital stay.
PURPOSE: The aim of our study was to evaluate the safety and effectiveness of early enteral nutrition (EN) for patients after pancreatoduodenectomy (PD). METHODS: We performed a comprehensive search of abstracts in the MEDLINE database, OVID database, Springer database, the Science Citation Index, and the Cochrane Library database. Published data of randomized clinical trials (RCTs) comparing the clinically relevant outcomes of early EN and other nutritional routes for patients after PD were analyzed. The analyzed outcome variables included gastroparesis, intra-abdominal complications (gastroparesis excluded), mortality, infection, and postoperative hospital stay. The Cochrane Collaboration's RevMan 5.1 software was used for statistical analysis. RESULTS: Four RCTs published in 2000 or later were included in this meta-analysis, in which 246 patients underwent early EN and 238 patients underwent other nutritional routes following PD. In the combined results of early EN versus other nutritional routes, no significant difference could be found in gastroparesis (odds ratio (OR), 0.89; 95 % CI, 0.36-2.18; P = 0.79), intra-abdominal complications (gastroparesis excluded) (OR, 0.82; 95 % CI, 0.53-1.26; P = 0.37), mortality (OR, 0.43; 95 % CI, 0.11-1.62; P = 0.21), infection (OR, 0.55; 95 % CI, 0.29-1.07; P = 0.08), postoperative hospital stay (mean difference, -0.93; 95 % CI, -6.51 to 4.65; P = 0.74). CONCLUSIONS: Current RCTs suggests that early EN appears safe and tolerated for patients after PD, but does not show advantages in infection and postoperative hospital stay.
Authors: Shu You Peng; Jian Wei Wang; Wan Yee Lau; Xiu Jun Cai; Yi Ping Mou; Ying Bin Liu; Jiang Tao Li Journal: Ann Surg Date: 2007-05 Impact factor: 12.969
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Authors: Georgia Herbert; Rachel Perry; Henning Keinke Andersen; Charlotte Atkinson; Christopher Penfold; Stephen J Lewis; Andrew R Ness; Steven Thomas Journal: Cochrane Database Syst Rev Date: 2019-07-22
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Authors: Georgia Herbert; Rachel Perry; Henning Keinke Andersen; Charlotte Atkinson; Christopher Penfold; Stephen J Lewis; Andrew R Ness; Steven Thomas Journal: Cochrane Database Syst Rev Date: 2018-10-24