[Show abstract][Hide abstract] ABSTRACT: To compare the different prognosis between enteral nutrition (EN) and parenteral nutrition (PN) in patients after gastrointestinal surgery (GIS), and to investigate a reasonable regimen of enteral nutrition (EN) after GIS.
Randomized controlled trials (RCTs) on EN/PN after GIS from 1970 to 2008 retrieved from the data bank of Pubmed, EMBASE and Cochrane Library were analyzed. Evaluation endpoints were anastomotic dehiscence, infection (catheter sepsis, wound infection, pneumonia, intra-abdominal abscess and urinary tract infection), vomiting and abdominal distention, other complications, length of hospital stay and mortality rate.
Twenty-three RCTs including 2784 patients met the entering criteria. Compared with PN, EN was beneficial in the reduction of anastomotic dehiscence (RR = 0.67, 95%CI: 0.50 - 0.91; P = 0.010), infections (RR = 0.72, 95% CI: 0.64 - 0.81; P < 0.001), other complication (RR = 0.82, 95%CI: 0.73 - 0.92; P < 0.001) and duration of hospital stay (weighted mean difference: -3.60; 95%CI: -3.88 - -3.32; P < 0.001). But the risk of vomiting was increased among patients with EN (RR = 1.39, 95%CI: 1.21 - 1.59; P < 0.001), and there was no significant differences in mortalities between the two groups (P = 0.400).
There is no advantage in treating patients 'nil by mouth' after gastrointestinal surgery. It indicated that early commencement of enteral feeding is beneficial.
No preview · Article · Sep 2009 · Zhonghua wai ke za zhi [Chinese journal of surgery]
[Show abstract][Hide abstract] ABSTRACT: To study the clinical value analyzing of colorectal cancer prognosis by the Sixth Edition TNM Stages.
5481 cases with colorectal cancer and treated by operational methods, were collected. All the cases were separately staged by the Fifth Edition or Sixth Edition TNM Stages standards. The 5-year survival rates were analyzed by the life table method.
The 5-year survival rates of the Fifth Edition TNM Stages of I, II, III and IV were 80.1%, 68.0%, 40.5% and 9.8% respectively. The 5-year survival rates of the Sixth Edition TNM Stages of II(A) and II(B) were 71.6% and 66.4% respectively, and of the stages III(A), III(B) and III(C) were 46.2%, 40.1% and 28.3% respectively. There were statistical differences among the sub-stages II and III, P < 0.05.
The Sixth edition TNM Stages laid more stress on effect of the local infiltration depths and lymphatic metastasis in the prognosis of colorectal cancer, therefore, the stages were more fine, to analyze prognosis of the colorectal cancer were more precise. It is high clinical value for the individual complex treatment with every sub-stages.
No preview · Article · Apr 2006 · Zhonghua yi xue za zhi