Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and Meta-Analysis
<i>Background</i>: Endoscopic submucosal dissection (ESD) for gastric cancer is increasingly performed worldwide due to its efficacy and safety. This study aimed to assess the evidence of the impact of early vs. delayed feeding after ESD on quality of care, which remains to be fully dete...
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| Format: | Article |
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MDPI AG
2020-11-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1010-660X/56/12/653 |
| _version_ | 1797707891297222656 |
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| author | Jun Watanabe Joji Watanabe Kazuhiko Kotani |
| author_facet | Jun Watanabe Joji Watanabe Kazuhiko Kotani |
| author_sort | Jun Watanabe |
| collection | DOAJ |
| description | <i>Background</i>: Endoscopic submucosal dissection (ESD) for gastric cancer is increasingly performed worldwide due to its efficacy and safety. This study aimed to assess the evidence of the impact of early vs. delayed feeding after ESD on quality of care, which remains to be fully determined. <i>Methods:</i> Electronic databases (PubMed, the Cochrane Central Register of Controlled Trials, EMBASE) and the trial registries (the World Health Organization International Clinical Trials Platform Search Portal and ClinicalTrials.gov) were searched for studies performed prior to September 2020. Study selection, data abstraction, and quality assessment were independently performed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Self-rated satisfaction and hospital stay were chiefly analyzed. <i>Results</i>: Two randomized controlled trials (239 patients) were included. The early and delayed post-ESD feeding groups had similar rates of post-ESD bleeding (risk ratio 1.90, 95% CI 0.42 to 8.63; I<sup>2</sup> = 0%). Early post-ESD feeding resulted in increased patients’ satisfaction in comparison to delayed post-ESD feeding (standard mean difference (MD) 0.54, 95% CI 0.27 to 0.81; I<sup>2</sup> = 0%) and reduced the length of hospital stay (MD −0.83, 95% CI −1.01 to −0.65; I<sup>2</sup> = 0%). <i>Conclusion</i>: Early post-ESD feeding was associated with increased patients’ satisfaction and reduced hospital stay in comparison to delayed feeding, while the rate of complications did not differ to a statistically significant extent. As we must acknowledge the limited number of reviewed studies, various trials regarding the quality of care are further needed to determine the benefits of early feeding after ESD. |
| first_indexed | 2024-03-12T06:14:12Z |
| format | Article |
| id | doaj.art-ed7f17d2dc6a4c538107cf38e23c5dd1 |
| institution | Directory Open Access Journal |
| issn | 1010-660X |
| language | English |
| last_indexed | 2024-03-12T06:14:12Z |
| publishDate | 2020-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-ed7f17d2dc6a4c538107cf38e23c5dd12023-09-03T02:48:15ZengMDPI AGMedicina1010-660X2020-11-015665365310.3390/medicina56120653Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and Meta-AnalysisJun Watanabe0Joji Watanabe1Kazuhiko Kotani2Division of Community and Family Medicine, Jichi Medical University, Shimotsuke-City, Tochigi 329-0498, JapanDepartment of Surgery, Iwami Hospital, Iwami-Town, Tottori 681-0003, JapanDivision of Community and Family Medicine, Jichi Medical University, Shimotsuke-City, Tochigi 329-0498, Japan<i>Background</i>: Endoscopic submucosal dissection (ESD) for gastric cancer is increasingly performed worldwide due to its efficacy and safety. This study aimed to assess the evidence of the impact of early vs. delayed feeding after ESD on quality of care, which remains to be fully determined. <i>Methods:</i> Electronic databases (PubMed, the Cochrane Central Register of Controlled Trials, EMBASE) and the trial registries (the World Health Organization International Clinical Trials Platform Search Portal and ClinicalTrials.gov) were searched for studies performed prior to September 2020. Study selection, data abstraction, and quality assessment were independently performed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Self-rated satisfaction and hospital stay were chiefly analyzed. <i>Results</i>: Two randomized controlled trials (239 patients) were included. The early and delayed post-ESD feeding groups had similar rates of post-ESD bleeding (risk ratio 1.90, 95% CI 0.42 to 8.63; I<sup>2</sup> = 0%). Early post-ESD feeding resulted in increased patients’ satisfaction in comparison to delayed post-ESD feeding (standard mean difference (MD) 0.54, 95% CI 0.27 to 0.81; I<sup>2</sup> = 0%) and reduced the length of hospital stay (MD −0.83, 95% CI −1.01 to −0.65; I<sup>2</sup> = 0%). <i>Conclusion</i>: Early post-ESD feeding was associated with increased patients’ satisfaction and reduced hospital stay in comparison to delayed feeding, while the rate of complications did not differ to a statistically significant extent. As we must acknowledge the limited number of reviewed studies, various trials regarding the quality of care are further needed to determine the benefits of early feeding after ESD.https://www.mdpi.com/1010-660X/56/12/653dietendoscopic submucosal dissectionfastingmeta-analysisstomach neoplasmspatient satisfaction |
| spellingShingle | Jun Watanabe Joji Watanabe Kazuhiko Kotani Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and Meta-Analysis Medicina diet endoscopic submucosal dissection fasting meta-analysis stomach neoplasms patient satisfaction |
| title | Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and Meta-Analysis |
| title_full | Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and Meta-Analysis |
| title_fullStr | Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and Meta-Analysis |
| title_short | Early vs. Delayed Feeding after Endoscopic Submucosal Dissection for Gastric Cancer: A Systematic Review and Meta-Analysis |
| title_sort | early vs delayed feeding after endoscopic submucosal dissection for gastric cancer a systematic review and meta analysis |
| topic | diet endoscopic submucosal dissection fasting meta-analysis stomach neoplasms patient satisfaction |
| url | https://www.mdpi.com/1010-660X/56/12/653 |
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