Document Detail


Application of perioperative immunonutrition for gastrointestinal surgery: a meta-analysis of randomized controlled trials.
MedLine Citation:
PMID:  17392114     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of this study was to evaluate clinical and economic validity of perioperative immunonutrition and effect on postoperative immunity in patients with gastrointestinal cancers. Immunonutrition diet supplemented two or more of nutrients including glutamine, arginine, omega-3 polyunsaturated fatty acids and ribonucleic acids. A meta-analysis of all relevant clinical randomized controlled trials (RCTs) was performed. The trials compared perioperative immunonutrition diet with standard diet. We extracted RCTs from electronic databases: Cochrane Library, MEDLINE, EMBASE, SCI and assessed methodological quality of them according handbook for Cochrane reviewer in June 2006. Statistical analysis was performed by RevMan4.2 software. Thirteen RCTs involving 1269 patients were included. The combined results showed that immunonutrition had no significant effect on postoperative mortality (OR =0.91, p= 0.84). But it had positive effect on postoperative infection rate (OR =0.41, p<0.00001), length of hospital stay (WMD=-3.48, p<0.00001). Furthermore, it improved immune function by increasing total lymphocytes (WMD=0.40, p<0.00001), CD4 levels (WMD=11.39, p<0.00001), IgG levels (WMD=1.07, p=0.0005) and decreasing IL6 levels (WMD=-201.83, p<0.00001). At the same time, we did not found significant difference in CD8, IL2 and CRP levels . There were no serious side effects and two trials found low hospital cost. In conclusion, perioperative diet adding immunonutrition is effective and safe to decrease postoperative infection and reduce length of hospital stay through improving immunity of postoperative patients as compared with the control group. Further prospective study is required in children or critical patients with gastrointestinal surgery.
Authors:
Yamin Zheng; Fei Li; Baoju Qi; Bin Luo; Haichen Sun; Shuang Liu; Xiaoting Wu
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Asia Pacific journal of clinical nutrition     Volume:  16 Suppl 1     ISSN:  0964-7058     ISO Abbreviation:  Asia Pac J Clin Nutr     Publication Date:  2007  
Date Detail:
Created Date:  2007-03-29     Completed Date:  2007-06-14     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  9440304     Medline TA:  Asia Pac J Clin Nutr     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  253-7     Citation Subset:  IM    
Affiliation:
Department of General Surgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun street, Beijing 100053, China.
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MeSH Terms
Descriptor/Qualifier:
Arginine / administration & dosage
Cost-Benefit Analysis
Digestive System Surgical Procedures
Enteral Nutrition / methods*
Fatty Acids, Omega-3 / administration & dosage
Gastrointestinal Neoplasms / immunology,  mortality,  surgery*
Glutamine / administration & dosage
Humans
Immunity, Innate*
Infection / epidemiology
Length of Stay
Perioperative Care*
Postoperative Complications / epidemiology
RNA / administration & dosage
Randomized Controlled Trials as Topic
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fatty Acids, Omega-3; 56-85-9/Glutamine; 63231-63-0/RNA; 74-79-3/Arginine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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