Efficacy And Safety Ofearly Oral Feeding(≤3days) And Late Oral Feeding(≥7days) Following Total Laryngectomy :a Meta-analysis

Objective:To systematically evaluate the efficacy and safety of early oral intake(≤3days) and late oral intake(≥7days) following total laryngectomy. Methods:The research literature about early oral feeding and late oral intake following total laryngectomy was collected in Pub Med, EMBASE, Ovid, CBM, Wanfang database, CNKI, the Cochrane Library from inception to May 2015.Tow reviewers independently screened studies according to the inclusion and exclusion criteria,extracted data and evaluated the methodological quality of the included studies.Then meta-analysis was performed using the sofeware RevMan 5.2. Results: A total of 968 patients from 8 studies were included for the analysis, 591 patients who was early oral intake(≤3days) and 377 patients who waslate oral intake(≥7days). Meta analysis showed that early oral intake(≤3days) following total laryngectomy was superior to late oral intake(≥7days) in the aspects of the hospital length of stay[MD= 一3.22,95%C l(一6.26~一0.18),P=0.04];and those differences were statistically significant.In terms of pharyngocutaneous fistula[OR=1.31,95%CI:0.89~1.93,P=0.17],the results of both groups were similar and showed no statistically significant difference. Conciusions:Compared with late oral intake(≥7days) following total laryngectomy,early oral intake(≤3days)has shorter hospital length of stay,but pharyngocutaneous fistula was similar in two groups.It can be found that early oral intake(≤3days) has advantages and is worthy of promotion in clinical applications.For the quality restrictions and possible publication bias of the included stuides,more RCTs with high quality are required to further assess the effects.