title: Early enteral nutrition compared with parenteral nutrition for esophageal cancer patients after esophagectomy: a meta-analysis.
abstract: Early postoperative enteral nutrition (EN) after esophagectomy in esophageal cancer patient has been reported to be correlated with a better rehabilitation than parenteral nutrition (PN). However, a robust conclusion has not been achieved. Therefore, we performed a meta-analysis to compare the postoperative EN and PN in patients with esophageal cancer undergoing esophagectomy. Three electronic databases were searched for eligible studies to be included in the meta-analysis. The summary relative risk/weighted mean difference (RR/WMD) estimates and corresponding 95% confidence interval (CI) were calculated using fixed- and random-effects models. Ten studies met the inclusion criteria. The analysis demonstrated that the early postoperative EN could significantly decrease the pulmonary complications (RR = 0.37, 95% CI = 0.22-0.62, P = 0.00, test for heterogeneity: I(2) = 0.0%, P = 0.89) and anastomotic leakage (RR = 0.46, 95% CI = 0.22-0.96, P = 0.04, test for heterogeneity: I(2) = 0.0%, P = 0.66) compared with PN. On the eighth postoperative day, the EN group had a higher levels of albumin (WMD = 1.84, 95% CI = 0.47-3.21, P = 0.01, test for heterogeneity: I(2) = 84.5%, P = 0.00) and prealbumin (WMD = 12.96, 95% CI = 3.63-22.29, P = 0.01, test for heterogeneity: I(2) = 0.0%, P = 0.63) compared with the PN group. However, there was no difference in digestive complications between these two approaches (RR = 1.30, 95% CI = 0.79-2.13, P = 0.30, test for heterogeneity: I(2) = 0.0%, P = 0.97). For patients with esophageal cancer following esophagectomy, the early postoperative EN support could decrease the morbidity of severe complications, such as pulmonary complications and anastomotic leakage, and maintain patients at a better nutritional status than parenteral nutrion support.
authors.affiliation: Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: J
authors.initials: J
authors.lastname: Peng
authors.affiliation: Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: J
authors.initials: J
authors.lastname: Cai
authors.affiliation: Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: Z-X
authors.initials: ZX
authors.lastname: Niu
authors.affiliation: Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: L-Q
authors.initials: LQ
authors.lastname: Chen
mesh_terms: D004750:Enteral Nutrition / Q000379:methods / Q000706:statistics & numerical data; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery; D016629:Esophagectomy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D015596:Nutrition Assessment; D010043:Outcome and Process Assessment, Health Care; D010288:Parenteral Nutrition / Q000379:methods / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000145:classification / Q000175:diagnosis / Q000517:prevention & control*
keywords: enteral nutrition; esophageal cancer; esophagectomy; meta-analysis; parenteral nutrition