Evidence map›Paper›PMID 33595685›Full record

SynthesisPediatric surgery international2021

Early enteral feeding after intestinal anastomosis in children: a systematic review and meta-analysis of randomized controlled trials.

Yuxin Tian, Haitao Zhu, Brian C Gulack, Mashriq Alganabi, Joshua Ramjist, Eric Sparks, Kaitlyn Wong, Chun Shen, Agostino Pierro

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Pediatric surgery international, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
1.8field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 3 countries.

Yuxin Tian *Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China.
Haitao Zhu *Department of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China.
Brian C Gulack *Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Mashriq AlganabiDivision of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Joshua RamjistDivision of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Eric SparksDivision of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Kaitlyn WongDivision of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada.
Chun ShenDepartment of Pediatric Surgery, Children's Hospital of Fudan University, Shanghai, China.
Agostino PierroDivision of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada. agostino.pierro@sickkids.ca.
Hospital for Sick Children · CAShanghai Children's Medical Center · CNChildren's Hospital of Fudan University · CNRush University Medical Center · USUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDelayed enteral feeding (DEF) contributes to postoperative complications among children undergoing intestinal surgery. Various recent studies indicate the benefits of early enteral nutrition after intestinal surgery in adults. This systematic review and meta-analysis evaluates whether early enteral feeding (EEF) is beneficial in children who underwent intestinal anastomosis.

methodsMEDLINE, PubMed, the Cochrane Library, and Web of Science databases were searched for RCTs that addressed the effect of EEF in children (younger than 18 years old) undergoing intestinal anastomosis. EEF was defined as starting enteral feeding before the 3rd postoperative day. Studies were selected based on predetermined inclusion and exclusion criteria. A meta-analysis was performed using RevMan 5.3 to estimate odds ratios (ORs) or mean differences (MDs) with 95% confidence intervals (CIs).

resultsFour RCT studies met the inclusion criteria, comprising 97 cases with EEF and 89 cases with DEF. Enteral feeding started significantly earlier in the EEF group compared to the DEF group (MD = - 2.80; 95% CI - 3.11 to - 2.49; p < 0.00001). Postoperative anastomotic leak rate was unchanged between EEF and DEF groups (OR = 0.86; 95% CI 0.17-4.46; p = 0.86). The EEF group had a shorter length of hospital stay (MD = - 3.38; 95% CI - 4.29 to - 2.48; p < 0.00001), earlier time to bowel movement return (MD = - 0.57; 95% CI - 0.79 to - 0.35; p < 0.00001), lower incidence of surgical infection (OR = 0.27; 95% CI 0.08-0.90; p = 0.03), and faster tolerance of full enteral feeding (MD = - 2.00; 95% CI - 3.01 to - 2.79; p < 0.00001). Incidence of fever (OR = 0.37; 95% CI 0.10-1.31; p = 0.12), emesis, and abdominal distention (OR = 0.63; 95% CI 0.13-3.16; p = 0.58) were not different between the two groups.

conclusionsEarly enteral feeding after intestinal anastomosis in children does not increase the risk of postoperative anastomotic leak, fever, emesis, and abdominal distention. However, early enteral feeding is beneficial as it promotes the return of bowel function, reduces the length of hospital stay and the incidence of surgical infection in comparison to delayed enteral feeding.

Indexed as

Anastomosis, SurgicalEnteral NutritionAdolescentAdultAnastomotic LeakChildDigestive System Surgical ProceduresHumansIntestinesLength of StayPediatricsPostoperative ComplicationsPostoperative PeriodRandomized Controlled Trials as TopicTime FactorsEarly enteral feedingEnhanced recovery after surgeryIntestinal anastomosisPediatric

Identifiers

PMID33595685
OpenAlexW3130805624

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.