Home enteral nutrition and oral nutritional supplements in postoperative patients with upper gastrointestinal malignancy: A systematic review and meta-analysis

He, Xi; li, Liu; Yang, Meng; Chen, Yuqing; Zhang, Pengcheng; Qiu, Lihong; Jun-e, Zhang

doi:10.1016/j.clnu.2020.11.023

Cited by 22 publications

(15 citation statements)

References 51 publications

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“…Healthcare costs are also vital evidence of home enteral nutritional support. It was found that the healthcare costs of home enteral nutritional support are higher than the normal oral diet, chiefly related to the cost of enteral nutrition agents (53). However, we could not evaluate it since studies did adjust or outline this factor.…”

Section: Discussionmentioning

confidence: 97%

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

et al. 2022

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IntroductionWe 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.MethodsA 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.ResultsHome 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.ConclusionsHome 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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Section: Discussionmentioning

confidence: 97%

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

et al. 2022

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“…Given that, we believe that our postoperative data for EC is not bad at all. The ESPEN 2020 guidelines assert the importance of early perioperative enteral nutritional management, but there is no evidence of how long it should last [24] . As a result of examining the cases in our institution regarding esophageal-specific function and symptoms [15] , the total scores tended to increase until about half a year after the operation [Figure 4].…”

Section: Discussionmentioning

confidence: 99%

How to maintain nutritional status after esophagectomy via the Tanaka method

Tanaka¹,

Sato²,

Suetsugu³

et al. 2021

JCMT

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Aim: Many therapeutic means have emerged to treat esophageal cancer. Factors relating to nutritional status such as body weight maintenance are important to the continuation of these treatments. In this study, we investigated methods to extend the administration of diversified treatments for patients with esophageal cancer, especially regarding measures to suppress body weight loss after surgery. Methods:We retrospectively evaluated a strategy for preventing postoperative body weight loss which can hinder the continuation of treatment via a reconstruction method aimed at safety and comfort combined with postoperative dietary intake and nutritional support for esophageal cancer patients. Results:The subjects comprised 386 patients who underwent subtotal stomach reconstruction during esophageal cancer surgery performed from January 2008 to January 2021 at Gifu University Hospital. The anastomotic leakage rate was 0.5%. By administering oral nutritional supplementation under strict rules using ENSURE® H during the perioperative period, the percentage of body weight loss after 5 years could be limited to 4.78% compared to that before treatment. Scores assessing early feeling of fullness measured using the EORTC QLQ-OES18 at postoperative months 3,

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“…However, PEG placement in patients with dysphagia resulted in a signi cant increase in caloric intake by 30.5%, protein intake by 26.0% and a conversion of the protein balance from negative to neutral in a study of 117 patients in a geriatric centre [22]. For cancer patients, a recent metaanalysis that included 1059 patients with upper gastrointestinal tract cancer showed that HEN also reduced the incidence of malnutrition and latent malnutrition (RR: 0.54; p < 0.01) [23].…”

Section: Discussionmentioning

confidence: 99%

Home Enteral Nutrition in Adults: Effectiveness of Nutritional Therapy and Educational Programme

Madrid-Paredes

Leyva-Martínez

Ávila-Rubio

et al. 2021

Preprint

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PurposeHome Enteral Nutrition (HEN) is used to prevent or correct malnutrition in outpatients. Due to the complexity of this process, the indication, follow-up, and results of an educational programme of HEN patients was evaluated.MethodsA prospective, observational, real-life, multicentre study of patients receiving HEN by nasogastric tube or ostomy in 21 hospitals was conducted. The following variables were collected: age, gender, HEN indication, type of formula, nutritional requirements, laboratory variables, complications, and quality standards of the educational programme. All data were analysed using SPSS.24.Results414 patients were included. Most conditions diagnosed were neurodegenerative diseases (64.8%). 100 patients (25.3%) were diabetic. The mean weight was 59.3±10.4kg and BMI 22.6±3.2. Moderate protein-calorie malnutrition was predominant at baseline (46.4%). Improvement in nutritional status at six months was recorded in more than 75% of patients (p<0.05). Tolerance problems, diarrhoea and abdominal distension fell between the 3- and 6-month visits (p <0.05). Patients who received intermittent Enteral Nutrition (EN) had fewer tolerance-related effects (OR: 0.042; 95% CI: 0.006-0.279) and less diarrhoea (OR: 0.042; 95% CI: 0.006-0.279), while those who received EN via nasogastric tube had fewer tolerance-related effects (OR: 0.042; 95% CI: 0.006-0.279). At the baseline and 6-month visits, compliance with the educational measures proposed by the prescriber was ≥ 99%. ConclusionThe nutritional assessment to prescribe individualised HEN to each patient, together with educational measures and training in the proper use of this treatment for both patients and trainers, improves nutritional status and reduces the onset of adverse reactions.

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Home enteral nutrition and oral nutritional supplements in postoperative patients with upper gastrointestinal malignancy: A systematic review and meta-analysis

Cited by 22 publications

References 51 publications

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

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

How to maintain nutritional status after esophagectomy via the Tanaka method

Home Enteral Nutrition in Adults: Effectiveness of Nutritional Therapy and Educational Programme

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