Evaluate the Effect of Home Enteral Nutrition Compared with Oral Diet after the Hospital Discharge of Subjects with Esophagectomy of Esophageal Cancer: A Systemic Review and Meta-analysis

Abstract

Background: We performed a meta-analysis to evaluate the effect of home enteral nutrition compared with oral diet after the hospital discharge of subjects with esophagectomy of esophageal cancer. Methods: A systematic literature search up to July 2021 was performed and 12 studies included 970 subjects with esophagectomy of esophageal cancer at the start of the study; 481 of them were using home enteral nutrition after the hospital discharge and 579 were given oral diet. They were reporting relationships between the effects of home enteral nutrition compared with oral diet after the hospital discharge of subjects with esophagectomy of esophageal cancer. We calculated the odds ratio (OR) and the mean difference (MD) with 95% confidence intervals (CIs) to assess the effects of home enteral nutrition compared with oral diet after the hospital discharge of subjects with esophagectomy of esophageal cancer using the dichotomous and contentious method with a random or fixed-effect model. Results: Home enteral nutrition had significantly higher body weight (MD, 31.4; 95% CI, 2.55-3.72, p < 0.001), body mass index (MD, 1.20; 95% CI, 0.66-1.74, p < 0.001), and serum albumin (MD, 3.14; 95% CI, 2.07-4.20, p < 0.001), hemoglobin (MD, 8.57; 95% CI, 6.52–10.63, p < 0.001), total protein (MD, 4.86; 95% CI, 2.93-6.80, p < 0.001), and pre-albumin (MD, 30.39; 95% CI, 1.27-59.50, p = 0.04) compared to oral diet after the hospital discharge of subjects with esophagectomy of esophageal cancer. Additionally, home enteral nutrition compared with oral diet after the hospital discharge of subjects with esophagectomy of esophageal cancer had no significant difference in feeding-related complications (OR, 1.04; 95% CI, 0.44-2.43, p = 0.93). Conclusions: Home enteral nutrition had significantly higher body weight, body mass index, and serum albumin, hemoglobin, total protein, and pre-albumin compared to oral diet after the hospital discharge of subjects with esophagectomy of esophageal cancer with no significant difference in feeding-related complications. Furthers studies are needed to confirm these findings.