title: Optimal postoperative nutrition support for patients with gastrointestinal malignancy: A systematic review and meta-analysis.
abstract: To improve clinical outcomes, parenteral nutrition, standard enteral nutrition and immuno-enhanced nutrition are widely used in the gastrointestinal tumor patients undergoing surgery, but the optimal management of postoperative nutrition support remains uncertain.
  
  
  
  We systematically searched the PUBMED, EMBASE and CNKI to identify latent studies which the effects of standard EN compared with PN or IEN on gastrointestinal tumor patients until the end of November, 2015. The quality of included trials was assessed according to the handbook for Cochrane reviewer. Statistical analysis was carried out by RevMan5.1 software.
  
  
  
  30 randomized controlled trials containing 3854 patients were contained in our meta-analysis, the results indicated that postoperative SEN could absolutely reduce the incidence of postoperative infectious (P < 0.00001) and non-infectious complications (P = 0.0003), together with its positive effect on the length of hospital stay (P < 0.00001). Additionally, enteral nutrition enhanced with immune stimulation was confirmed to be better, with a significant difference between groups in terms of total infectious (P < 0.00001) and non-infectious complications (P = 0.04), and IEN could also significantly shorten the length of hospital stay (P < 0.00001).
  
  
  
  Early use of Enteral nutrition in digestive tumor patients after surgery could significantly reduce the postoperative complications and shorten the length of hospital stay, IEN should be the optimal management, while the use of parenteral nutrition should be restrict to few patients with severe intolerance to enteral nutrition.
authors.affiliation: Zhongnan Hospital of Wuhan University, Department of Oncology, Wuhan University, Wuhan, 430071, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Yan
authors.affiliation: Zhongnan Hospital of Wuhan University, Department of Oncology, Wuhan University, Wuhan, 430071, China. Electronic address: fxzhouwhu@gmail.com.
authors.forename: Fu-Xiang
authors.initials: FX
authors.lastname: Zhou
authors.affiliation: Zhongnan Hospital of Wuhan University, Department of Oncology, Wuhan University, Wuhan, 430071, China.
authors.forename: Tian
authors.initials: T
authors.lastname: Lan
authors.affiliation: Zhongnan Hospital of Wuhan University, Department of Oncology, Wuhan University, Wuhan, 430071, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
authors.affiliation: Zhongnan Hospital of Wuhan University, Department of Oncology, Wuhan University, Wuhan, 430071, China.
authors.forename: Xiao-Xi
authors.initials: XX
authors.lastname: Yang
authors.affiliation: Zhongnan Hospital of Wuhan University, Department of Oncology, Wuhan University, Wuhan, 430071, China.
authors.forename: Cong-Hua
authors.initials: CH
authors.lastname: Xie
authors.affiliation: Zhongnan Hospital of Wuhan University, Department of Oncology, Wuhan University, Wuhan, 430071, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Dai
authors.affiliation: Zhongnan Hospital of Wuhan University, Department of Oncology, Wuhan University, Wuhan, 430071, China.
authors.forename: Zhen-Ming
authors.initials: ZM
authors.lastname: Fu
authors.affiliation: Zhongnan Hospital of Wuhan University, Department of Oncology, Wuhan University, Wuhan, 430071, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Zhongnan Hospital of Wuhan University, Department of Oncology, Wuhan University, Wuhan, 430071, China.
authors.forename: Lu-Lu
authors.initials: LL
authors.lastname: Chen
mesh_terms: D004750:Enteral Nutrition; D005770:Gastrointestinal Neoplasms / Q000628:therapy*; D006801:Humans; D010288:Parenteral Nutrition; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic
keywords: Enteral nutrition; Gastrointestinal cancer; Immune; Meta-analysis; Parenteral nutrition; Surgery