术后早期经口进食对食管癌患者预后影响的meta分析

目的 采用meta分析评估术后早期经口进食对食管癌患者的影响，评价其安全性和有效性。方法 计算机检索PubMed、Web of Science、Cochrane Library、 EMBSCO、中国知网、万方数据库以及维普数据库建库至2022年6月发表的关于食管癌术后患者早期经口进食的干预性研究。由2名评价人员按照纳排标准独立筛选文献、提取资料、评价文献质量。采用RevMan 5.3软件对提取资料进行Meta分析。结果 共纳入6篇文献，涉及到1306例食管切除术后患者。Meta分析结果显示食管癌切除患者术后早期经口进食组较传统进食组术后首次排气时间（MD=－1.11，95%CI（－1.25，－0.96），P＜0.00001）、术后首次排便时间（MD=－1.68，95%CI（－2.13，－1.22），P＜0.00001）、术后肺部并发症发生率（RR=0.76，95%CI（0.58，0.99），P=0.04）、术后住院时间（MD=－3.40，95%CI（－5.30，－1.49），P=0.0005）、术后生活质量（MD=4.77，95%CI（2.27，7.26），P=0.0002），差异具有统计学意义；术后吻合口瘘发生率（RR=0.88，95%CI（0.55，1.41），P=0.59）、术后乳糜胸发生率（RR=0.72，95%CI（0.22，2.38），P=0.59），差异不具有统计学差异。结论 meta分析结果基本稳定可靠，食管癌术后早期经口进食有助于促进胃肠功能早期恢复、减少术后肺部并发症发生率、不增加术后吻合口瘘和乳糜胸等并发症发生率，具有安全性和有效性。

Meta-analysis of the influence of early oral feeding on the prognosis of patients after esophagectomy

Objective To evaluate the safety and effectiveness of early oral feeding in patients with esophagectomy by meta-analysis. Methods We searched in PubMed, Web of Science, Cochrane Library, EMBSCO, CNKI,Wanfang and VIP database for the literature related to the early oral feeding in patients with esophagectomy from inception to June 2022. According to the inclusion and exclusion criteria, two reviewers independently screened the literature, extracted the data, and evaluated the literature quality, then, meta-analysis was performed by using RevMan 5.3 software. Results Meta-analysis, included 6 literatures involving 1306 patients, showed the group fo early oral feeding than traditional feeding group, the first time of flatus(MD = 1.11, 95% CI (1.25, 0.96), P < 0.00001), the first defecation time (MD = 1.68, 95% CI (2.13, 1.22), P < 0.00001), incidence of postoperative pulmonary complications (RR=0.76, 95%CI (0.58, 0.99), P=0.04), length of postoperative hospital stay (MD=-3.40, 95%CI (-5.30, -1.49), P=0.0005), postoperative quality of life (MD=4.77, 95%CI (2.27, 7.26), P=0.0002), the difference was statistically significant; There was no statistical difference in the incidence of postoperative anastomotic leakage (RR=0.88, 95%CI (0.55, 1.41), P=0.59) and postoperative chylothorax (RR=0.72, 95%CI (0.22, 2.38), P=0.59). Conclusion The meta-analysis results are basically stable and reliable. Early oral feeding after esophagectomy can promote the early recovery of gastrointestinal function, reduce the incidence of postoperative pulmonary complications, and do not increase the incidence of postoperative anastomotic fistula and chylothorax, which is safe and effective.