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SYSTEMATIC REVIEW article

Front. Oncol.
Sec. Gastrointestinal Cancers: Gastric and Esophageal Cancers
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1390065

An updated systematic review and meta-analysis of the efficacy and safety of early oral feeding vs. traditional oral feeding after gastric cancer surgery

Provisionally accepted
Dong Xu Dong Xu Junping Li Junping Li Jinchao Liu Jinchao Liu Pingjiang Wang Pingjiang Wang Jianjian Dou Jianjian Dou *
  • Zibo Municipal Hospital, Zibo, China

The final, formatted version of the article will be published soon.

    Early oral feeding (EOF) has been showed to improve postoperative recovery for many surgeries. However, surgeons are still skeptical about EOF after gastric cancer surgery due to possible side effects. An updated systematic review and meta-analysis aimed to investigate the efficacy and safety of EOF in patients after gastric cancer surgery.Methods: Randomized controlled trials (RCTs) investigating EOF in patients after gastric cancer surgery were searched in the databases of Pubmed, Embase, Clinicaltrials.gov and Cochrane from 2005 to 2023 and an updated meta-analysis was performed using RevMan 5.4 software.The results of 11 RCTs involving 1352 patients were included and scrutinized in this analysis. Hospital days (Weighted Mean difference (WMD) -1.72; 95% confidence interval (CI) -2.14 to -1.30; P<0.00001), the time to first flatus (WMD -0.72; 95% CI -0.99 to -0.46; P<0.00001) and hospital costs (WMD -3.78; 95% CI -4.50 to -3.05; P<0.00001) were significantly decreased in the EOF group. Oral feeding tolerance (risk ratio (RR) 1.00; 95% CI 0.95 to 1.04; P=0.85), readmission rates (RR 1.28; 95% CI 0.50 to 3.28; P=0.61), postoperative complications (RR 1.02; 95% CI 0.81 to 1.29; P=0.84), anastomotic leakage (RR 0.83; 95% CI 0.25 to 2.78; P=0.76) and pulmonary infection (RR 0.65; 95% CI 0.31 to 1.39; P=0.27) were not significantly statistical between two groups.This meta-analysis reveals that EOF could reduce hospital days, the time to first flatus and hospital costs, but it was not associated with oral feeding tolerance, readmission rates or postoperative complications especially anastomotic leakage and pulmonary infection, regardless of whether laparoscopic or open surgery, partial or total gastrectomy, or the timing of EOF initiation.

    Keywords: Early oral feeding, Traditional oral feeding, gastric cancer, Gastrectomy, Meta-analysis

    Received: 22 Feb 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Xu, Li, Liu, Wang and Dou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Jianjian Dou, Zibo Municipal Hospital, Zibo, 255400, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.