{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T13:41:07Z","timestamp":1760881267220,"version":"build-2065373602"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aspenjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Parenter Enteral Nutr"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Certain guidelines consider feeding within 4\u2009h of percutaneous endoscopic gastrostomy tube (PEG) placement to be safe. However, the evidence supporting the recommendations has been questioned and variation in feeding initiation practices persists, with feeding delayed up to 24\u2009h after PEG placement. Our objective was to systematically review the current literature on early vs delayed feeding after PEG placement and compare their outcome in a meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ovid MEDLINE, EMBASE, Cochrane Library, CINAHL, and Web of Science were searched from inception until December 4, 2023. Randomized and nonrandomized studies comparing feeding initiation \u22644 vs &gt;4\u2009h post\u2010PEG in adults were included. Independent extraction was conducted following the Preferred Reporting Items for Systematic Reviews and Meta\u2010Analysis reporting guidelines and data were pooled using fixed or random\u2010effects models. Measured outcomes were the odds of postoperative vomiting, diarrhea, stoma leakage, stoma infection, bleeding, intra\u2010abdominal infection, aspiration pneumonia, and 30\u2010day mortality. Assessment of risk of bias was completed using the Cochrane risk of bias tool 2 (RoB 2) for randomized studies and the Newcastle\u2010Ottawa scale for nonrandomized studies. GRADE was used to assess evidence certainty. PROSPERO registration: CRD42023483520.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 4751 studies, 11 with 2880 patients met inclusion. There was no significant difference in all the measured outcomes between groups, but the evidence certainty was low to very low. Intra\u2010abdominal infection couldn't be examined because of scarce reporting by authors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This robust meta\u2010analysis suggests early feeding after PEG placement is likely safe but uncertain, highlighting the need for a high\u2010quality randomized trial.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jpen.2774","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T08:09:43Z","timestamp":1747987783000},"page":"682-691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes of early compared with delayed initiation of feeding after placement of percutaneous endoscopic gastrostomy tube: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6345-1533","authenticated-orcid":false,"given":"Mudathir","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Department of General Surgery Maimonides Medical Center Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ceilidh","family":"McKenney","sequence":"additional","affiliation":[{"name":"Department of General Surgery Maimonides Medical Center Brooklyn New York USA"},{"name":"School of Medicine, St. George's University St. George Grenada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilla Sophia","family":"Rossi","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Weill Cornell Medicine New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan Khader","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"New York City Health and Hospitals Jacobi Bronx New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1205-2014","authenticated-orcid":false,"given":"Ahmed","family":"Alnajar","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery University of Miami Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianmarco","family":"Cancelli","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery Weill Cornell Medicine New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"McKenney","sequence":"additional","affiliation":[{"name":"School of Medicine, St. George's University St. George Grenada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Demetres","sequence":"additional","affiliation":[{"name":"Samuel J. Wood Library and C.V. Starr Biomedical Information Center Weill Cornell Medicine New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zi","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of General Surgery Maimonides Medical Center Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Nicastro","sequence":"additional","affiliation":[{"name":"Department of General Surgery Maimonides Medical Center Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel","family":"Horovitz","sequence":"additional","affiliation":[{"name":"Department of General Surgery Maimonides Medical Center Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607115621863"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3468(80)80296-X"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.09.012"},{"issue":"5","key":"e_1_2_8_5_1","article-title":"Percutaneous endoscopic gastrostomy versus nasogastric tube feeding for adults with swallowing disturbances","volume":"2015","author":"Gomes CA","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02108.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e3181eeb732"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607114526887"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/1751143715599410"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0148607116673053"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2019.04.022"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-1331-8080"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2010.10.021"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2011.06.001"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.5946\/ce.2023.062"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1005552227119"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dld.2011.04.003"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2022.01.006"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-5-13"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5107(96)70134-7"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1998.00419.x"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-002-1473-5"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-013-0348-8"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/SMJ.0000000000000104"},{"issue":"2","key":"e_1_2_8_26_1","first-page":"75","article-title":"Immediate tube feeding after percutaneous endoscopic gastrostomy: early return to goal tube feeds without added complications","volume":"81","author":"Lamb LC","year":"2017","journal-title":"Conn Med"},{"issue":"3","key":"e_1_2_8_27_1","first-page":"1058","article-title":"Early versus delayed feeding after placement of percutaneous endoscopic gastrostomy tube with safe anesthetic techniques","volume":"31","author":"Abdalgaleil M","year":"2018","journal-title":"Menoufia Med J"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.2303"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2023.10.012"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.2575"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15051157"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2010197"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000153413.46627.3A"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.2502"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.36.2.1321"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnesp.2023.07.001"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.14309\/01.ajg.0000862988.41737.08"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2021.11.026"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c3920"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2005.09.016"}],"container-title":["Journal of Parenteral and Enteral Nutrition"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jpen.2774","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T13:05:54Z","timestamp":1760879154000},"score":1,"resource":{"primary":{"URL":"https:\/\/aspenjournals.onlinelibrary.wiley.com\/doi\/10.1002\/jpen.2774"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":39,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1002\/jpen.2774"],"URL":"https:\/\/doi.org\/10.1002\/jpen.2774","archive":["Portico"],"relation":{},"ISSN":["0148-6071","1941-2444"],"issn-type":[{"type":"print","value":"0148-6071"},{"type":"electronic","value":"1941-2444"}],"subject":[],"published":{"date-parts":[[2025,5,23]]},"assertion":[{"value":"2024-11-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-04-28","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-05-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}