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Title: | EFFECTIVENESS OF EARLY ADMINISTRATION OF STANDARD ENTERAL FEEDING POST-PANCREATICODUODENECTOMY SURGERY IN REDUCING LENGTH OF HOSPITAL STAY: A SYSTEMATIC REVIEW AND META-ANALYSIS | Authors: | SUM HSIN YIN CLAIRE | Keywords: | Pancreaticoduodenectomy Enteral nutrition Parenteral nutrition Length of stay Solid diet Systematic review |
Issue Date: | 25-May-2019 | Citation: | SUM HSIN YIN CLAIRE (2019-05-25). EFFECTIVENESS OF EARLY ADMINISTRATION OF STANDARD ENTERAL FEEDING POST-PANCREATICODUODENECTOMY SURGERY IN REDUCING LENGTH OF HOSPITAL STAY: A SYSTEMATIC REVIEW AND META-ANALYSIS. ScholarBank@NUS Repository. | Abstract: | Background: Pancreaticoduodenectomy (PD) is the main treatment option for patients with cancer of the head of pancreas, a malignancy with increasing global prevalence. It is important that patients receive proper nutrition post-PD to prevent malnutrition. However, it is poorly understood if enteral nutrition (EN) or parenteral nutrition (PN) is more effective for recovery. Objectives: To review current available evidence to determine the effectiveness of EN as compared to PN in lowering the hospital length of stay (HLOS), and on reducing the time to initiate solid diet. Methods: A systematic search of six databases (CINAHL, Embase, ProQuest Dissertations and Theses, PubMed, Scopus and The Cochrane Library) was conducted. Published primary research studies, including randomised controlled trials and retrospective studies, reporting the effectiveness of EN compared to PN in patients post-PD were deemed eligible for inclusion. Two independent reviewers extracted data and assessed the quality of the studies. Meta-analyses were conducted for the primary and secondary outcomes, followed by sensitivity testing and subgroup analyses where appropriate. Results: Eight studies (nine arms) were included in this review. Meta-analysis on the primary outcome revealed that EN significantly lowers the HLOS of post-PD patients, as opposed to PN (MD=1.74, 95% CI [0.46 to 3.01], p=0.008). The secondary outcome of initiation of solid diet showed no significant difference whether EN or PN was used (MD=0.84, 95% CI [-1.02 to 2.70], p=0.37). Conclusions and Implications: EN is more beneficial than PN in reducing the HLOS, but the time to initiate solid diet was not influenced by the route of adminstration. More high quality RCTs can be conducted in future, for a wider number to allow physicians to make more informed decisions on the route of artificial nutrition administration best suited for their patients. | URI: | https://scholarbank.nus.edu.sg/handle/10635/154105 |
Appears in Collections: | Bachelor's Theses |
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