ArticleJournal of gastrointestinal oncology2025
Parenteral nutrition versus enteral nutrition after gastric cancer surgery: a systematic review and meta-analysis of randomized controlled trials.
Article in Journal of gastrointestinal oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Gastric cancer is a major cause of cancer mortality globally, and surgery is the primary curative treatment. Postoperative malnutrition is common and can delay recovery. Providing effective nutritional support after surgery is therefore essential, but whether parenteral nutrition (PN) or enteral nutrition (EN) offers greater clinical benefit remains unclear. This study aimed to compare the effects of PN and EN on hospital stay and nutritional outcomes in gastric cancer patients after surgery. Methods: A thorough search of PubMed, Web of Science, Embase, and Cochrane Library databases was conducted following the PICOS principles to identify randomized controlled trials (RCTs) published up to August 2025. Eligible studies enrolled gastric cancer patients who received either PN or EN after surgery, reporting on length of hospital stay, nutritional markers (albumin, prealbumin, CD4/CD8 ratio), and adverse events. Two authors independently extracted data and assessed risk of bias using the Cochrane RoB 2.0 tool. Results: Nine RCTs were included, with 641 patients in the PN group and 637 in the EN group. The risk of bias among included studies was generally moderate. Length of hospital stay was longer with EN than with PN [weighted mean difference =3.45, 95% confidence interval (CI): 2.29-4.61, P<0.001]. Albumin levels were higher with EN on days 1 and 8. Prealbumin levels were higher with PN on days 1 and 8. No significant difference was detected between PN and EN regarding retinol-binding protein levels on day 8 and the CD4/CD8 ratio on day 1. Infectious complications were more frequent with EN than with PN [relative risk (RR) =1.55, 95% CI: 1.06-2.27, P=0.02]. No significant difference was observed between EN and PN concerning overall complications (RR =1.11, 95% CI: 0.89-1.40, P=0.35). Conclusions: Compared with EN, PN could shorten the hospital stay, increase the prealbumin levels, and decrease the occurrence of infectious complications, while albumin levels were higher with EN than with PN. However, given the moderate risk of bias and heterogeneity among included studies, further high-quality RCTs are needed to determine the optimal nutritional support strategy in this population.
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