The current study aimed to summarize valid and up-to-date high-quality evidence to compare the impact of early oral feeding(EOF)and delay oral feeding(DOF)among patients undergoing gastrectomy.A comprehensive literature review of the PubMed,Cochrane library,Medline,Embase,the CNKI,Wangfang Library and CBM databases was conducted from the earliest data of each to May 2021.Studies were selected to compare the EOF protocol versus DOF protocol undergoing gastrectomy.The primary outcome assessed was anastomotic leaks.Secondary outcomes included time to passage of flatus,postoperative ileus and postoperative length of hospital stay(LOS).Analysis was performed with Review Manager 5.3 software.Sisteen studies,comprising of 3477 patients were included in the analysis.There was no significant difference in risk of anastomotic leak(odds ratio[OR]0.73;95%confidence interval[CI]0.45 to 1.20;P=0.22;I^(2)=0%;P=0.47)and postoperative ileus(OR 1.61;95%CI 0.93 to 2.77;P=0.09;I^(2)=0%,P=0.85)between the EOF and DOF groups.Patients had a reduction in time to passage of flatus(WMD-0.66d;95%CI-0.86 to-0.46;P<0.001;I^(2)=94%;P<0.001),and postoperative LOS(WMD-1.66d,95%CI-1.97 to-1.35,P<0.001;I^(2)=65%).EOF as compared with DOF is not associated with an increase in clinically relevant complications,Moreover,EOF is associated with shorter LOS and early the recovery of gastrointestinal function.
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