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Effect of Early Versus Late Oral Feeding on Postoperative Complications and Recovery Outcomes for Patients with Esophageal Cancer: A Systematic Evaluation and Meta-Analysis

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study aimed to systematically evaluate the effect of early oral feeding (EOF) versus late oral feeding (LOF) on postoperative complications and rehabilitation outcomes for patients with esophageal cancer.

Methods

This study searched relevant literature published up to March 2023 by computer retrieval of PubMed, Embase, The Cochrane Library, and Web of Science. A meta-analysis was performed using Review Manager 5.4 software to compare the effects of EOF and LOF on postoperative complications and recovery outcomes of patients with esophageal cancer.

Results

The study included 14 articles, including 9 retrospective studies, 4 randomized controlled trials (RCTs), and 1 prospective study. The 2555 patients included in the study comprised 1321 patients who received EOF and 1234 patients who received LOF. The results of the meta-analysis showed that compared with the LOF group, the EOF group has a shorter time to the first flatus postoperatively (mean difference [MD],  −  1.12; 95% confidence interval [CI], (−  1.25 to −  1.00; P < 0.00001), a shorter time to the first defecation postoperatively (MD, −  1.31; 95% CI, −  1.67 to −   0.95;, P < 0.00001], and a shorter hospital stay postoperatively (MD, −  2.87; 95% CI, −  3.84 to −  1.90; P < 0.00001). The two groups did not differ significantly statistically in terms of postoperative anastomotic leakage rate (P = 0.10), postoperative chyle leakage rate (P = 0.10), or postoperative pneumonia rate (P = 0.15).

Conclusion

Early oral feeding after esophageal cancer surgery can shorten the time to the first flatus and the first defecation postoperatively, shorten the hospital stay, and promote the recovery of patients. Moreover, it has no significant effect on the incidence of postoperative complications.

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Acknowledgment

This research was supported by the Gansu Province Key R&D Project (22YF7FA095).

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Funding

Gansu Province Key R&D Project, (22YF7FA095).

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Authors and Affiliations

  1. Department of Thoracic Surgery, Gansu Provincial Hospital, Lanzhou, China

    Ziqiang Hong MD, Yingjie Lu MD, Hongchao Li MD, Tao Cheng MD, Baiqiang Cui MD, Xusheng Wu MD, Dacheng Jin MD & Yunjiu Gou MD

  2. Lanzhou First People’s Hospital, Lanzhou, China

    Yannan Sheng MD

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Contributions

Ziqiang Hong: Conceptualization, Methodology, Formal analysis, Investigation, Writing‒Original Draft, and Visualization. Yunjiu Gou and Jing Zhao: Conceptualization, Methodology, Formal analysis, Investigation, Writing‒Review & Editing, Visualization, and Supervision. Xiangdou Bai and Hongchao Li: Conceptualization, Methodology, Investigation, and Writing‒Review & Editing. Tao Cheng, Yingjie Lu and Yannan Sheng: Conceptualization, Methodology, Writing‒Review & Editing, and Supervision. Baiqiang Cui, Xusheng Wu and Dacheng Jin: Conceptualization, Methodology, Writing‒Review & Editing, and Supervision.

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Correspondence to Yunjiu Gou MD.

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Hong, Z., Lu, Y., Li, H. et al. Effect of Early Versus Late Oral Feeding on Postoperative Complications and Recovery Outcomes for Patients with Esophageal Cancer: A Systematic Evaluation and Meta-Analysis. Ann Surg Oncol 30, 8251–8260 (2023). https://doi.org/10.1245/s10434-023-14139-2

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