Effect of Home Enteral Nutritional Support Compared With Normal Oral Diet in Postoperative Subjects With Upper Gastrointestinal Cancer Resection: A Meta-Analysis

家庭肠内营养支持与正常口服饮食对上消化道肿瘤切除术后患者的影响:一项荟萃分析

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Abstract

INTRODUCTION: We performed a meta-analysis to evaluate the influence of a home enteral nutritional support compared with a normal oral diet in postoperative subjects with upper gastrointestinal cancer resection. METHODS: A systematic literature search up to December 2021 was done and 23 studies included 3,010 subjects with upper gastrointestinal cancer resection at the start of the study; 1,556 of them were given home enteral nutritional support and 1,454 were normal oral diet. We calculated the odds ratio (OR) and mean difference (MD) with 95% CIs to evaluate the influence of home enteral nutritional support compared with a normal oral diet in postoperative subjects with upper gastrointestinal cancer resection by the dichotomous or continuous methods with a random or fixed-influence model. RESULTS: Home enteral nutritional support had significantly higher quality of life (MD, 2.08; 95% CI, 1.50-2.67, p < 0.001), better body weight change (MD, 1.87; 95% CI, 1.31-2.43, p < 0.001), higher albumin (MD, 1.27; 95% CI, 0.72-1.82, p < 0.001), and higher pre-albumin (MD, 30.79; 95% CI, 7.29-54.29, p = 0.01) compared to the normal oral diet in subjects with upper gastrointestinal cancer resection. However, home enteral nutritional support had no significant impact on the hemoglobin (MD, 4.64; 95% CI, -4.17 to 13.46, p = 0.30), and complications (OR, 1.03; 95% CI, 0.76-1.40, p = 0.83) compared to the normal oral diet in subjects with upper gastrointestinal cancer resection. CONCLUSIONS: Home enteral nutritional support had a significantly higher quality of life, better body weight change, higher albumin, and higher pre-albumin, and had no significant impact on the hemoglobin and complications compared to the normal oral diet in subjects with upper gastrointestinal cancer resection. Further studies are required.

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