Enteral versus Parenteral Nutrition after Gastrointestinal Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials in the English Literature

Mazaki, Takero; Ebisawa, Kiyoko

doi:10.1007/s11605-007-0362-1

Cited by 184 publications

(125 citation statements)

References 94 publications

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“…Several studies including some meta-analyses examine this topic (Baigrie et al, 1996;Velez et al, 1997;Bozzetti et al, 2001;Mazaki and Ebisawa, 2008). In short, the evidence favours enteral over parenteral nutrition.…”

Section: Enteral Feeding Routesmentioning

confidence: 99%

“…Several studies have suggested that following gastrointestinal surgery, enteral nutrition is superior to parenteral nutrition (PN), resulting in a reduced length of hospitalisation and serious postoperative complication rates (McCarter et al, 1996;Velez et al, 1997;Aiko et al, 2001;Gabor et al, 2005;Mazaki and Ebisawa, 2008). However, these benefits are not necessarily reproduced following oesophagectomy.…”

Section: Introductionmentioning

confidence: 99%

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Nutritional access routes following oesophagectomy—a systematic review

2011

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Section: Enteral Feeding Routesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Nutritional access routes following oesophagectomy—a systematic review

2011

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“…After many reports were issued on the benefits of enteral nutrition in critically ill patients [2,3], several experimental and clinical studies of gastrointestinal surgery have shown that traditional postoperative oral intake restriction is not based on scientific evidence. A number of recent randomized controlled trials and meta-analyses comparing early enteral nutrition and traditional postoperative fasting after gastrointestinal surgery have concluded that early postoperative enteral nutrition reduces postoperative morbidity (especially infectious complications), mortality, and hospital stay without increasing the risk of gastrointestinal-related complications [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

The safety and feasibility of early postoperative oral nutrition on the first postoperative day after gastrectomy for gastric carcinoma

et al. 2013

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Background Unlike the wide acceptance of early enteral nutrition after colorectal surgery, little information is available regarding the feasibility of immediate oral nutrition after gastric cancer surgery. This study evaluated the feasibility and safety of oral nutrition on the first postoperative day after gastrectomy. Methods From September 2010 to March 2011, 74 consecutive gastric cancer patients received an oral diet on the first postoperative day after gastrectomy. Surgical outcomes, including hospital stay, morbidity, and mortality, were compared with a conventional diet group (n = 96, before September 2010), in which an oral diet was started on the third or fourth postoperative day.Results No significant differences were found in the clinicopathological characteristics or operation types between the two groups. Average diet start times in the early diet (ED) and conventional diet (CD) groups were 1.8 and. 3.2, respectively (p \ 0.001). The mean hospital stay was significantly shorter in the ED group (7.4 vs. 8.9 days, p = 0.004). There was no significant difference in postoperative morbidity (p = 0.947) between the two groups. Gastrointestinal-related complications, such as anastomosis leakage or postoperative ileus, were also similar in the two groups. Overall compliance to early oral nutrition in the ED group was 78.5 %, and an old age (C70 years) was found to affect the compliance to early postoperative oral nutrition. Conclusions Postoperative oral nutrition is safe and feasible on the first postoperative day after gastrectomy. However, elderly patients require careful monitoring when applying early oral nutrition after gastrectomy.

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“…Enteral nutrition is considered to be better than total parenteral nutrition for providing feeding in various clinical settings because it is less expensive, safer and maintains the nutritional, metabolic, immunological and barrier function of the intestines with fewer septic complications [6][7][8][9][10]. Jejunostomy is a surgical procedure by which a tube is situated in the lumen of proximal jejunum, primarily to administer enteral nutrition or sometimes medications and on rare occasion to aspirate intestinal contents.…”

Section: Introductionmentioning

confidence: 99%

Study of Feeding Jejunostomy as an Add on Procedure in Upper Gastrointestinal Surgeries

Shenoy

Adapala

2013

Indian J Surg

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Jejunostomy is usually indicated as an additional procedure during major surgery of upper digestive tract to administer enteral nutrition in post-operative period. Complications associated with it can be mechanical, infectious, gastrointestinal or metabolic. The aim of the study was to evaluate safety of post-operative feeding jejunostomy in different types of major upper gastrointestinal surgeries. It was a prospective study conducted during the period between August 2009 and September 2011. Post-operative cases of major upper gastrointestinal surgeries who receive jejunostomy feeds were included in the study. Sampling was done by convenient method with sample size of 50 cases. Post-operatively, patients were monitored according to standard orders of enteral nutrition. Total calorie and protein intake through feeding jejunostomy was calculated regularly, and complications were assessed in terms of frequency, type, duration, management, and final outcome in different types of upper gastro intestinal surgeries. Analysis was done using chi square test with the help of statistical package SPSS vers.13. P < 0.05 was considered as significant. Complications observed were gastrointestinal −8 (16 %), mechanical −6 (12 %), infectious −4 (8 %) and metabolic −4 (8 %). Duration of complications ranged from 1 to 7 days (mean, 4 days). All types of complications observed during study were less severe and could be managed by simple measurements. Haemoglobin, serum albumin and weight of the patient at the time of discharge were improved for all patients when compared to pre-operative values. All patients received target calories and proteins through feeding jejunostomy. Considering benefits of enteral feeding via jejunostomy tube with minor and acceptable complications, we conclude that feeding jejunostomy is a preferred route of nutritional administration in those who undergo major upper gastro intestinal surgeries.

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Enteral versus Parenteral Nutrition after Gastrointestinal Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials in the English Literature

Abstract: The present findings would lead us to recommend the use of EN rather than PN when possible and indicated.

Cited by 184 publications

References 94 publications

Nutritional access routes following oesophagectomy—a systematic review

Nutritional access routes following oesophagectomy—a systematic review

The safety and feasibility of early postoperative oral nutrition on the first postoperative day after gastrectomy for gastric carcinoma

Study of Feeding Jejunostomy as an Add on Procedure in Upper Gastrointestinal Surgeries

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