Limited Efficacy of Early Enteral Nutrition in Patients after Total Gastrectomy

Li, Junsheng; Ji, Zhenling; Yuan, Cong-Wei; Zhang, Yanan; Chen, Weidong; Ju, Xingzhu; Tang, Wen-hao

doi:10.3109/08941939.2011.557469

Cited by 3 publications

(3 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This meta-analysis included 14 studies comparing EN and PN in gastric cancer resections. There were 10 papers from China, 3 papers from Japan, and 1 paper from Korea: Li et al [36], Wang et al [37], Li et al [38], Chen et al [1], Liu et al [39], Li et al [40], Gao [41], Hongyi et al [42], Chen [43], Li et al [44], Nomura et al [45], Akashi et al [46], Kamei et al [47], and Kim et al [48] . Nine papers were randomized with n = 1437 participants, and 5 papers were retrospective studies with n = 421 participants.…”

Section: Resultsmentioning

confidence: 99%

“…The levels of albumin on POD < 7 were reported in 6 studies [1, 36, 38–40, 44], with ( n = 1210) 609 participants in EN and 601 in PN groups. Heterogeneity was significant among studies that reported on PODs < 7 ( χ 2 = 44.98, P < 0.00001, I 2 = 89%), and PODs ≥ 7 was reported from 7 studies [1, 36, 38–40, 43, 44] ( χ 2 = 34.29, P < 0.00001, I 2 = 83%). Therefore, the random effect model was used to calculate the effect sizes for both periods.…”

Section: Resultsmentioning

confidence: 99%

“…This involved 4 studies ( n = 338) [37, 39, 44, 45]. Homogeneity across the studies was significant ( χ 2 = 4.88, df = 3 ( P = 0.18), I 2 = 39%).…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Short-term evaluation of immune levels and nutritional values of EN versus PN in gastric cancer: a systematic review and a meta-analysis

et al. 2019

View full text Add to dashboard Cite

Background Postsurgical patients’ oral feeding begins with clear fluids 1–3 days after surgery. This might not be sufficiently nutritious to boost the host immune system and provide sufficient energy in gastric neoplastic patients to achieve the goal of enhanced recovery after surgery (ERAS). Our objective was to analyze the significance of early postoperative feeding tubes in boosting patients’ immunity and decreasing incidence of overall complications and hospital stay in gastric cancer patients’ post-gastrectomy. Methods From January 2005 to May 24, 2019, PubMed and Cochrane databases were searched for studies involving enteral nutrition (EN) feeding tubes in comparison to parenteral nutrition (PN) in gastric cancer patients undergoing gastrectomy for gastric malignancies. Relative risk (RR), mean difference (MD), or standard mean difference (SMD) with 95% confidence interval (CI) were used to estimate the effect sizes, and heterogeneity was assessed by using Q and χ 2 statistic with their corresponding P values. All the analyses were performed with Review Manager 5.3 and SPSS version 22. Results Nine randomized trials ( n = 1437) and 5 retrospective studies ( n = 421) comparing EN feeding tubes and PN were deemed eligible for the pooled analyses, with a categorized time frame of PODs ≥ 7 and PODs < 7. Ratio of CD4+/CD8+ in EN feeding tubes was the only outcome of PODs < 7, which showed significance (MD 0.22, 95% CI 0.18–0.25, P < 0.00001). Regarding other immune indicators, significant outcomes in favor of EN feeding tubes were measured on POD ≥ 7: CD3+ (SMD 1.71; 95% CI 0.70, 2.72; P = 0.0009), CD4+ (MD 5.84; 95% CI 4.19, 7.50; P < 0.00001), CD4+/CD8+ (MD 0.28; 95% CI 0.20; 0.36, P < 0.00001), NK cells (SMD 0.94; 95% CI 0.54, 1.30; P < 0.00001), nutrition values, albumin (SMD 0.63; 95% CI 0.34, 0.91; P < 0.001), prealbumin (SMD 1.00; 95% CI 0.52, 1.48; P < 0.00001), and overall complications (risk ratio 0.73 M-H; fixed; 95% CI 0.58, 0.92; P = 0.006). Conclusion EN feeding tube support is an essential intervention to elevate patients’ immunity, depress levels of inflammation, and reduce the risk of complications after gastrectomy for gastric cancer. Enteral nutrition improves the innate immune system and nutrition levels but has no marked significance on certain clinical outcomes. Also, EN reduces the duration of hospital stay and cost, significantly.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Short-term evaluation of immune levels and nutritional values of EN versus PN in gastric cancer: a systematic review and a meta-analysis

et al. 2019

View full text Add to dashboard Cite

show abstract

Effects of an Oral Elemental Nutritional Supplement on Post-gastrectomy Body Weight Loss in Gastric Cancer Patients: A Randomized Controlled Clinical Trial

et al. 2016

View full text Add to dashboard Cite

show abstract

The Comparison between Early Enteral Nutrition and Total Parenteral Nutrition after Total Gastrectomy in Patients with Gastric Cancer: The Randomized Prospective Study

Kim

Chung

Kim

2012

Korean J Gastroenterol

View full text Add to dashboard Cite

Background/Aims: Early enteral nutrition (EEN) has benefits in reducing infectious complication, length of stay (LOS) and preserving liver function. There are few data about the effect of EEN in the patients who had total gastrectomy. The aim of this randomized and prospective study was to evaluate the effect of EEN after total gastrectomy on nutritional status, liver function, complications and LOS, compared to total parenteral nutrition (TPN) in patients with gastric cancer. Methods: Among 56 patients with gastric cancer, 36 and 20 were randomly assigned to EEN and TPN groups, and finally 17 and 16 completed EEN and TPN schedules, respectively. The nutritional parameters, liver function, LOS and abdominal symptoms were compared between 2 groups on pre-operative day and post-operative 7th day. Results: There was no significant difference in the nutritional parameters, liver function between EEN and TPN groups. Vomiting and abdominal distention were more frequent in EEN than TPN group (2 vs. 0 cases, p=0.485; 1 vs. 0 case, p=1.000, respectively), while increased AST, ALT and total bilirubin were more common in TPN than EEN group (4 vs. 2 cases, p=0.398; 1 vs. 0 case, p=0.485, respectively without statistical significance). LOS was shorter in EEN than TPN group without statistical significance (12 vs. 13 days, p=0.289). Conclusions: No significant differences were found in the nutritional status parameters, liver function, complications and LOS between EEN and TPN groups on 7th day after total gastrectomy. Further large scale studies on the advantages and disadvantages of EEN after total gastrectomy are warranted. (Korean J Gastroenterol 2012;59:407-413)

show abstract

Limited Efficacy of Early Enteral Nutrition in Patients after Total Gastrectomy

Abstract: Since there was no significant difference regarding either the postoperative recovery course or complications, the routine placement of a nasojejunal tube for EEN is unnecessary in elective total gastrectomy.

Cited by 3 publications

References 31 publications

Short-term evaluation of immune levels and nutritional values of EN versus PN in gastric cancer: a systematic review and a meta-analysis

Short-term evaluation of immune levels and nutritional values of EN versus PN in gastric cancer: a systematic review and a meta-analysis

Effects of an Oral Elemental Nutritional Supplement on Post-gastrectomy Body Weight Loss in Gastric Cancer Patients: A Randomized Controlled Clinical Trial

The Comparison between Early Enteral Nutrition and Total Parenteral Nutrition after Total Gastrectomy in Patients with Gastric Cancer: The Randomized Prospective Study

Contact Info

Product

Resources

About