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

Abstract

Introduction: We 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. Methods: A 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. Results: Home 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. Conclusions: Home 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.