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Enteral nutrition versus parenteral nutrition after major abdominal surgery in patients with gastrointestinal cancer: a systematic review and meta-analysis
  1. Xu-Fei Zhao1,
  2. Ning Wu2,
  3. Guo-Qiang Zhao1,
  4. Jian-Fang Liu1,
  5. Ye-Feng Dai1
  1. 1Department of Surgery, Children's Hospital of Zhejiang University of Medicine, Hangzhou, China
  2. 2Department of Surgery, First Affiliated Hospital of Zhejiang University of Medicine, Hangzhou, China
  1. Correspondence to Dr Ye-Feng Dai, Department of Surgery, Children's Hospital of Zhejiang University of Medicine, Bin sheng Road 3333, Hangzhou 310003, China; lucianfei{at}


To clarify the benefits of enteral nutrition (EN) versus total parenteral nutrition (TPN) in patients with gastrointestinal cancer who underwent major abdominal surgery. Medline, Cochrane, EMBASE, and Google Scholar were searched for studies published until July 10, 2015, reporting outcomes between the two types of postoperative nutritional support. Only randomized controlled trials (RCTs) were included. A χ2-based test of homogeneity was performed using Cochran's Q statistic and I2. A total of 2540 patients (1268 who received EN and 1272 who received TPN; average age range: 58.3–67.7 years) from 18 RCTs were included for assessment. Patients who received EN had shorter lengths of hospital stay (pooled difference in mean=−1.74, 95% CI −2.41 to −1.07, p<0.001, shorter time to flatus (pooled difference in mean=−1.27, 95% CI −1.69 to −0.85, p<0.001), and significantly greater increases in albumin levels (pooled difference in mean=−1.33, 95% CI −2.18 to −0.47, p=0.002) compared with those who received TPN after major abdominal surgery, based on a random-effects model of analysis. EN after major abdominal surgery provided better outcomes compared with TPN in patients with gastrointestinal cancer.

  • Abdomen

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