Early Enteral Versus Parenteral Nutrition After Abdominal Surgery In The Recovery Of Gastrointestinal Motility (A Systematic Review And Meta-analysis)

ObjectivesTo compare the difference between early enteral nutrition and parenteral nutrition in the recovery of gastrointestinal motility after abdominal surgery, and to determine whether a period of early enteral nutrition after abdominal surgery is beneficial.MethodsRandomized controlled trials (RCTs) on EN/PN after abdominal surgery from 1990 to 2010 retrieved from the data bank of PubMed,EMBASE,Cochrane Library were analyzed. Evaluation endpoints were nausea and vomiting, bowel sounds, flatus elimination, passage of stool, abdominal distention, nasogastric tube reinsertion, length of hospital stay.ResultFifteen RCTs including 2111 patients met the entering criteria. Compared with PN, EN was beneficial in promoting bowel sounds (WMD=-0.29,95%CI:-0.48--0.11;P=0.002),flatus elimination (WMD=-0.52,95%CI:-0.83--0.20;P=0.001).But the risks of nausea & vomiting (RR=1.25,95%CI:1.04-1.50;P=0.02),and nasogastric tube reinsertion (RR=1.50,95%CI:1.00-2.26;P=0.05) were increased among patients with EN.ConclusionThere was no significant difference in the time of passage of stool, the risks of abdominal distention and the length of hospital stay. To determine whether a period of early enteral nutrition after abdominal surgery should be considered.