Impact of early oral feeding on postoperative outcomes after elective colorectal surgery: a systematic review and meta-analysis.

IF 1.8 3区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Digestive Surgery Pub Date : 2024-11-18 DOI:10.1159/000542595

Soo Young Lee, Eon Chul Han

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引用次数: 0

Abstract

Introduction: This study aimed to evaluate the influence of early oral feeding (EOF), a key component of enhanced recovery after surgery protocols, on postoperative outcomes in patients undergoing elective colorectal surgery.

Methods: We searched the Medline, Embase, Cochrane Library, and KoreaMed databases to include randomized clinical trials comparing EOF that started on postoperative day 1 and conventional oral feeding that commenced after first flatus. Two authors independently screened the retrieved records and extracted data. The primary outcome was total complications. Data were pooled, and the overall effect size was calculated.

Results: We screened 13 studies, and 1,556 patients were included in the analysis. The EOF group exhibited fewer total complications (odds ratio [OR] 0.50; 95% confidence interval [CI] 0.38 to 0.65). Anastomotic leakage was also reduced in the EOF group (OR 0.40; 95% CI 0.19 to 0.83); however, an increased incidence of vomiting (OR 1.58; 95% CI 1.11 to 2.26) as well as a tendency of higher rate of nasogastric tube reinsertion (OR 1.49; 95% CI 0.96 to 2.31) were observed. The EOF group demonstrated a decreased time to flatus (mean difference [MD] -0.87; 95% CI -1.00 to -0.74) and shortened hospital stay (MD -0.76; 95% CI -0.89 to -0.6). No significant difference in mortality was observed between the two groups (OR 0.54; 95% CI 0.15 to 2.01).

Conclusion: EOF proved to be a safe and effective practice for patients undergoing elective colorectal surgery. However, the increased incidence of vomiting necessitates careful consideration.

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早期口服喂养对择期结直肠手术术后效果的影响：系统综述和荟萃分析。

简介：本研究旨在评估早期口服喂养（EOF）对择期结直肠手术患者术后效果的影响：本研究旨在评估早期口服喂食（EOF）对择期结直肠手术患者术后效果的影响：我们检索了 Medline、Embase、Cochrane Library 和 KoreaMed 数据库，将术后第 1 天开始的早期口服喂养与首次排气后开始的传统口服喂养进行比较的随机临床试验纳入其中。两位作者独立筛选了检索到的记录并提取了数据。主要结果是总并发症。汇总数据并计算总体效应大小：我们筛选了 13 项研究，共有 1556 名患者纳入分析。EOF 组的总并发症较少（几率比 [OR] 0.50；95% 置信区间 [CI] 0.38 至 0.65）。EOF 组的吻合口漏也有所减少（OR 0.40；95% CI 0.19 至 0.83）；但呕吐发生率增加（OR 1.58；95% CI 1.11 至 2.26），鼻胃管重新插入率也有上升趋势（OR 1.49；95% CI 0.96 至 2.31）。EOF 组缩短了排气时间（平均差 [MD] -0.87；95% CI -1.00 至 -0.74），缩短了住院时间（平均差 -0.76；95% CI -0.89 至 -0.6）。两组患者的死亡率无明显差异（OR 0.54；95% CI 0.15 至 2.01）：对于接受择期结直肠手术的患者来说，EOF 被证明是一种安全有效的方法。结论：对于接受择期结直肠手术的患者来说，EOF 被证明是一种安全有效的做法，但需要慎重考虑呕吐发生率的增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Digestive Surgery 医学-外科

CiteScore

4.90

自引率

3.70%

发文量

审稿时长

3 months

期刊介绍： ''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.