The Effect of immunonutrition in patients undergoing pancreaticoduodenectomy: a systematic review and meta-analysis
Abstract Background Pancreaticoduodenectomy (PD) is a complex and traumatic abdominal surgery with a high risk of postoperative complications. Nutritional support, including immunonutrition (IMN) with added glutamine, arginine, and ω-3 polyunsaturated fatty acids, can improve patients’ prognosis by...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-04-01
|
| Series: | BMC Cancer |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12885-023-10820-7 |
| _version_ | 1827961239129554944 |
|---|---|
| author | Yinyin Fan Nianxing Li Jing Zhang Qiaomei Fu Yudong Qiu Yan Chen |
| author_facet | Yinyin Fan Nianxing Li Jing Zhang Qiaomei Fu Yudong Qiu Yan Chen |
| author_sort | Yinyin Fan |
| collection | DOAJ |
| description | Abstract Background Pancreaticoduodenectomy (PD) is a complex and traumatic abdominal surgery with a high risk of postoperative complications. Nutritional support, including immunonutrition (IMN) with added glutamine, arginine, and ω-3 polyunsaturated fatty acids, can improve patients’ prognosis by regulating postoperative inflammatory response. However, the effects of IMN on PD patients’ outcomes require further investigation. Methods PMC, EMbase, web of science databases were used to search literatures related to IMN and PD. Data such as length of hospital stay, infectious complications, non-infectious complications, postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), mortality, systemic inflammatory response syndrome (SIRS) duration, IL-6, and C-reactive protein (CRP) were extracted, and meta-analyses were performed on these data to study their pooled results, heterogeneity, and publication bias. Results This meta-analysis involved 10 studies and a total of 572 patients. The results showed that the use of IMN significantly reduced the length of hospital stay for PD patients (MD = -2.31; 95% CI = -4.43, -0.18; P = 0.03) with low heterogeneity. Additionally, the incidence of infectious complications was significantly reduced (MD = 0.42; 95% CI = 0.18, 1.00, P = 0.05), with low heterogeneity after excluding one study. However, there was no significant impact on non-infectious complications, the incidence of POPF and DGE, mortality rates, duration of SIRS, levels of IL-6 and CRP. Conclusion The use of IMN has been shown to significantly shorten hospital stays and decrease the frequency of infectious complications in PD patients. Early implementation of IMN is recommended for those undergoing PD. However, further research is needed to fully assess the impact of IMN on PD patients through larger and higher-quality studies. |
| first_indexed | 2024-04-09T16:23:35Z |
| format | Article |
| id | doaj.art-194f0d5234d84485b03c740cf47b3c12 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-09T16:23:35Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-194f0d5234d84485b03c740cf47b3c122023-04-23T11:20:12ZengBMCBMC Cancer1471-24072023-04-0123111310.1186/s12885-023-10820-7The Effect of immunonutrition in patients undergoing pancreaticoduodenectomy: a systematic review and meta-analysisYinyin Fan0Nianxing Li1Jing Zhang2Qiaomei Fu3Yudong Qiu4Yan Chen5Department of Biliary-Pancreatic Surgery, Nanjing Drum Tower Hospital Clinical College of Jiangsu UniversityDepartment of Biliary-Pancreatic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Biliary-Pancreatic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Biliary-Pancreatic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Biliary-Pancreatic Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Biliary-Pancreatic Surgery, Nanjing Drum Tower Hospital Clinical College of Jiangsu UniversityAbstract Background Pancreaticoduodenectomy (PD) is a complex and traumatic abdominal surgery with a high risk of postoperative complications. Nutritional support, including immunonutrition (IMN) with added glutamine, arginine, and ω-3 polyunsaturated fatty acids, can improve patients’ prognosis by regulating postoperative inflammatory response. However, the effects of IMN on PD patients’ outcomes require further investigation. Methods PMC, EMbase, web of science databases were used to search literatures related to IMN and PD. Data such as length of hospital stay, infectious complications, non-infectious complications, postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), mortality, systemic inflammatory response syndrome (SIRS) duration, IL-6, and C-reactive protein (CRP) were extracted, and meta-analyses were performed on these data to study their pooled results, heterogeneity, and publication bias. Results This meta-analysis involved 10 studies and a total of 572 patients. The results showed that the use of IMN significantly reduced the length of hospital stay for PD patients (MD = -2.31; 95% CI = -4.43, -0.18; P = 0.03) with low heterogeneity. Additionally, the incidence of infectious complications was significantly reduced (MD = 0.42; 95% CI = 0.18, 1.00, P = 0.05), with low heterogeneity after excluding one study. However, there was no significant impact on non-infectious complications, the incidence of POPF and DGE, mortality rates, duration of SIRS, levels of IL-6 and CRP. Conclusion The use of IMN has been shown to significantly shorten hospital stays and decrease the frequency of infectious complications in PD patients. Early implementation of IMN is recommended for those undergoing PD. However, further research is needed to fully assess the impact of IMN on PD patients through larger and higher-quality studies.https://doi.org/10.1186/s12885-023-10820-7PancreaticoduodenectomyImmunonutritionPrognosisLength of hospital stayInfectious complications |
| spellingShingle | Yinyin Fan Nianxing Li Jing Zhang Qiaomei Fu Yudong Qiu Yan Chen The Effect of immunonutrition in patients undergoing pancreaticoduodenectomy: a systematic review and meta-analysis BMC Cancer Pancreaticoduodenectomy Immunonutrition Prognosis Length of hospital stay Infectious complications |
| title | The Effect of immunonutrition in patients undergoing pancreaticoduodenectomy: a systematic review and meta-analysis |
| title_full | The Effect of immunonutrition in patients undergoing pancreaticoduodenectomy: a systematic review and meta-analysis |
| title_fullStr | The Effect of immunonutrition in patients undergoing pancreaticoduodenectomy: a systematic review and meta-analysis |
| title_full_unstemmed | The Effect of immunonutrition in patients undergoing pancreaticoduodenectomy: a systematic review and meta-analysis |
| title_short | The Effect of immunonutrition in patients undergoing pancreaticoduodenectomy: a systematic review and meta-analysis |
| title_sort | effect of immunonutrition in patients undergoing pancreaticoduodenectomy a systematic review and meta analysis |
| topic | Pancreaticoduodenectomy Immunonutrition Prognosis Length of hospital stay Infectious complications |
| url | https://doi.org/10.1186/s12885-023-10820-7 |
| work_keys_str_mv | AT yinyinfan theeffectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT nianxingli theeffectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT jingzhang theeffectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT qiaomeifu theeffectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT yudongqiu theeffectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT yanchen theeffectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT yinyinfan effectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT nianxingli effectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT jingzhang effectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT qiaomeifu effectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT yudongqiu effectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis AT yanchen effectofimmunonutritioninpatientsundergoingpancreaticoduodenectomyasystematicreviewandmetaanalysis |