Impact of perioperative immunonutrition on postoperative outcomes in pancreaticoduodenectomy: a systematic review and meta-analysis of randomized controlled trials.

IF 2.5 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

BMC Gastroenterology Pub Date : 2024-11-16 DOI:10.1186/s12876-024-03510-6

Gaofeng Zhang, Bing Zhao, Tengang Deng, Xiaofei He, Yongpin Chen, Changtao Zhong, Jie Chen

{"title":"Impact of perioperative immunonutrition on postoperative outcomes in pancreaticoduodenectomy: a systematic review and meta-analysis of randomized controlled trials.","authors":"Gaofeng Zhang, Bing Zhao, Tengang Deng, Xiaofei He, Yongpin Chen, Changtao Zhong, Jie Chen","doi":"10.1186/s12876-024-03510-6","DOIUrl":null,"url":null,"abstract":"Background: This systematic review and meta-analysis aimed to evaluate the impact of perioperative immunonutrition on postoperative outcomes in patients undergoing pancreaticoduodenectomy (PD).Methods: Conducted a comprehensive search in PubMed, Embase, Cochrane Library, Medline, and Web of Science databases to identify all randomized controlled trials (RCTs) on the topic of immunonutrition and PD. Subsequently screened literature, extracted data, and assessed the risk of bias in the included studies, and finally conducted a meta-analysis using RevMan 5.3 software.Results: The analysis included a total of 10 RCTs with 574 patients, among whom 288 were in the immunonutrition group and 283 in the control group. The meta-analysis revealed a significantly lower incidence of postoperative infection-related complications (OR = 0.45; 95% CI: 0.27-0.74; P = 0.002) and severe postoperative complications (OR = 0.61; 95% CI: 0.38-0.98; P = 0.04) in the immunonutrition group compared to the control group. Additionally, patients in the immunonutrition group had a significantly shorter length of hospital stay (MD= -1.87; 95%CI -3.29 - -0.44; P = 0.01). However, the analysis revealed no statistically significant difference in the overall complication rate between the two groups (P = 0.67). Furthermore, the incidence of specific complications and perioperative mortality rates also did not demonstrate any statistically significant differences (all P > 0.05).Conclusions: Perioperative immunonutrition in PD patients can reduce postoperative infection-related complications, but more high-quality RCTs are needed for further validation.","PeriodicalId":9129,"journal":{"name":"BMC Gastroenterology","volume":"24 1","pages":"412"},"PeriodicalIF":2.5000,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11569618/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12876-024-03510-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: This systematic review and meta-analysis aimed to evaluate the impact of perioperative immunonutrition on postoperative outcomes in patients undergoing pancreaticoduodenectomy (PD).

Methods: Conducted a comprehensive search in PubMed, Embase, Cochrane Library, Medline, and Web of Science databases to identify all randomized controlled trials (RCTs) on the topic of immunonutrition and PD. Subsequently screened literature, extracted data, and assessed the risk of bias in the included studies, and finally conducted a meta-analysis using RevMan 5.3 software.

Results: The analysis included a total of 10 RCTs with 574 patients, among whom 288 were in the immunonutrition group and 283 in the control group. The meta-analysis revealed a significantly lower incidence of postoperative infection-related complications (OR = 0.45; 95% CI: 0.27-0.74; P = 0.002) and severe postoperative complications (OR = 0.61; 95% CI: 0.38-0.98; P = 0.04) in the immunonutrition group compared to the control group. Additionally, patients in the immunonutrition group had a significantly shorter length of hospital stay (MD= -1.87; 95%CI -3.29 - -0.44; P = 0.01). However, the analysis revealed no statistically significant difference in the overall complication rate between the two groups (P = 0.67). Furthermore, the incidence of specific complications and perioperative mortality rates also did not demonstrate any statistically significant differences (all P > 0.05).

Conclusions: Perioperative immunonutrition in PD patients can reduce postoperative infection-related complications, but more high-quality RCTs are needed for further validation.

查看原文本刊更多论文

围手术期免疫营养对胰十二指肠切除术术后效果的影响：随机对照试验的系统回顾和荟萃分析。

背景：本系统综述和荟萃分析旨在评估围手术期免疫营养对胰十二指肠切除术（PD）患者术后效果的影响：本系统综述和荟萃分析旨在评估围手术期免疫营养对胰十二指肠切除术（PD）患者术后效果的影响：在PubMed、Embase、Cochrane Library、Medline和Web of Science数据库中进行全面检索，以确定所有以免疫营养和胰十二指肠切除术为主题的随机对照试验（RCT）。随后筛选文献、提取数据并评估纳入研究的偏倚风险，最后使用RevMan 5.3软件进行荟萃分析：分析共纳入了10项研究，574名患者，其中免疫营养组288人，对照组283人。荟萃分析显示，与对照组相比，免疫营养组术后感染相关并发症（OR = 0.45；95% CI：0.27-0.74；P = 0.002）和严重术后并发症（OR = 0.61；95% CI：0.38-0.98；P = 0.04）的发生率明显较低。此外，免疫营养组患者的住院时间明显缩短（MD=-1.87；95%CI -3.29-0.44；P = 0.01）。不过，分析结果显示，两组患者的总体并发症发生率没有明显的统计学差异（P = 0.67）。此外，特定并发症的发生率和围手术期死亡率也未显示出任何有统计学意义的差异（P均>0.05）：结论：腹膜透析患者围手术期免疫营养可减少术后感染相关并发症，但还需要更多高质量的 RCT 进行进一步验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BMC Gastroenterology 医学-胃肠肝病学

CiteScore

4.20

自引率

0.00%

发文量

465

审稿时长

6 months

期刊介绍： BMC Gastroenterology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of gastrointestinal and hepatobiliary disorders, as well as related molecular genetics, pathophysiology, and epidemiology.