A scoping review of preoperative weight loss interventions on postoperative outcomes for patients with gastrointestinal cancer

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2024-10-11 DOI:10.1016/j.ejso.2024.108743

Yangyue Zhang , Natalia Tomborelli Bellafronte , Gezal Najafitirehshabankareh , Michelle Huamani Jimenez , Emily Jaeger-McEnroe , Hughes Plourde , Mary Hendrickson , Chelsia Gillis

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引用次数: 0

Abstract

Background

Obesity is associated with increased risk of surgical complications in some settings.

Objective

As a precursor to a systematic review, we conducted a scoping review of intentional preoperative weight loss to describe these interventions, their feasibility and effectiveness for patients with gastrointestinal cancer.

Methods

In April 2024, Ovid MEDLINE, EMBASE, CINAHL, and Google Scholar were searched for primary studies of intentional weight loss before elective gastrointestinal cancer surgery. Extracted data encompassed recruitment and attrition, intervention types, adherence, anthropometric and body composition changes, and surgical outcomes. Study quality was assessed using the Risk of Bias In Non-randomized Studies of Interventions tool.

Results

The search produced 7 articles (4 non-randomized clinical trials), which were all conducted in Japan, and involved 258 participants with a baseline BMI ≥25 kg/m². Weight loss interventions included dietary modification (n = 3), exercise (n = 1), and combination (n = 3). None of the articles reported rates of recruitment, 2 adherence (97–100 %), and 4 reported attrition rates (0–18 %). All reported weight reductions of −1.3 to −6 kg and 4.5–6.9 % (n = 7), compared to baseline. Three of four non-randomized trials observed a reduction in postoperative complications, as compared to control; yet all trials were at critical risk of bias.

Conclusion

Strong conclusions could not be made due to the limited reporting and critical risk of bias; further systematic review is not recommended at this time. To establish more robust evidence, there is a clear need for high-quality trials.

查看原文本刊更多论文

胃肠道癌症患者术前减肥干预对术后效果的影响范围综述。

背景：肥胖与某些情况下手术并发症的风险增加有关：在某些情况下，肥胖与手术并发症风险增加有关：作为系统性综述的前奏，我们对有意进行的术前减重进行了范围界定，以描述这些干预措施及其对胃肠道癌症患者的可行性和有效性：2024 年 4 月，我们在 Ovid MEDLINE、EMBASE、CINAHL 和 Google Scholar 中检索了有关胃肠道癌症择期手术前有意减重的主要研究。提取的数据包括招募和减员情况、干预类型、坚持情况、人体测量和身体成分变化以及手术结果。研究质量采用非随机干预研究中的偏倚风险工具进行评估：检索结果显示，共有7篇文章（4项非随机临床试验），均在日本进行，涉及258名基线体重指数≥25 kg/m2的参与者。减肥干预措施包括饮食调整（3 篇）、运动（1 篇）和综合疗法（3 篇）。没有一篇文章报告了招募率，2 篇报告了坚持率（97%-100%），4 篇报告了减员率（0%-18%）。与基线相比，所有文章均报告体重减轻了-1.3 至-6 千克和 4.5-6.9 %（n = 7）。四项非随机试验中有三项观察到，与对照组相比，术后并发症有所减少；但所有试验都存在严重的偏倚风险：由于报告有限且存在严重的偏倚风险，因此无法得出有力的结论；目前不建议进行进一步的系统性审查。要建立更可靠的证据，显然需要进行高质量的试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.