Economic value of nutritional support methods in gastrointestinal cancer: A quantitative meta-analysis.

BACKGROUND AND OBJECTIVES: Multiple studies of the relative economic value of different nutritional support methods for patients with gastrointestinal cancer have provided inconsistent results. METHODS AND STUDY DESIGN: The PUBMED and EMBASE databases were systematically searched through September 30, 2018to identify latent studies of the benefits of parenteral nutrition (PN), enteral nutrition (EN) or conventional intervention (CI) in gastrointestinal cancer patients. A fixed-effects model or random-effects model was applied depending on the heterogeneity of the studies. Statistical analysis was conducted using R software. A total of 728 studies were reviewed, and 21 studies published from 1998 to 2018 were included in the final analysis. RESULTS: The results showed that the hospitalization expenditure of the EN group was 3938 RMB less than that of the PN group. Similarly, the EN group had a shorter length of hospitalization than the PN and CI groups. The infection rate was lower in the EN group (12%) than in the PN group (16%) and CI group (20%). Subgroup analysis showed that gastrointestinal cancer patients who received oral nutritional supplements had the lowest infection rate (11%) after surgery. CONCLUSIONS: EN, especially oral nutritional supplements, has a positive economic impact on patients with gastrointestinal cancer, based on reductions in the post-operative infection rate, length of hospitalization, and hospitalization expenditure.