Clinical evidence of growth hormone for patients undergoing abdominal surgery: meta-analysis of randomized controlled trials.
OBJECTIVE
To assess the effectiveness and safety of perioperative growth hormone (GH) in patients undergoing abdominal surgery.


METHODS
We searched the following electronic databases: MEDLINE, EMBASE, the Cochrane Controlled Trials Register, Chinese Bio-medicine Database. The search was undertaken in February 2003. No language restrictions were applied. Randomized controlled trials (RCT) comparing GH with placebo in patients undergoing abdominal surgery were extracted and evaluated. Methodological quality was evaluated using the Jadad scale.


RESULTS
Eighteen trials involving 646 patients were included. The combined results showed that GH had a positive effect on improving postoperative nitrogen balance (standardized mean difference (SMD) = 3.37, 95%CI (2.46, 4.27), P<0.00001), and decreasing the length of hospital stay (weighted mean difference (WMD) = -2.07, 95%CI (-3.03, -1.11), P = 0.00002), and reducing the duration of postoperative fatigue syndrome (SMD = -1.83, 95%CI (-2.37, -1.30), P<0.00001), but it could increase blood glucose levels (WMD = 0.91, 95%CI (0.56, 1.25), P<0.00001).


CONCLUSIONS
GH for patients undergoing abdominal surgery is effective and safe, if blood glucose can be controlled well. Further trials are required with a sufficient size to account for clinical heterogeneity and to measure other important outcomes such as infection, morbidity, mortality, fluid retention, immunomodulatory effects, and tumor recurrence.
Department of General Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu 610041, Sichuan Province, China. nutritioner@163.com
Yong
Y
Zhou
Xiao-Ting
XT
Wu
Gang
G
Yang
Wen
W
Zhuang
Mao-Ling
ML
Wei
D000005:Abdomen / Q000601:surgery*; D001786:Blood Glucose / Q000378:metabolism; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology; D013006:Growth Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007902:Length of Stay; D009584:Nitrogen / Q000378:metabolism; D011183:Postoperative Complications; D011184:Postoperative Period; D016032:Randomized Controlled Trials as Topic; D013577:Syndrome; D013997:Time Factors
D001786:Blood Glucose; D013006:Growth Hormone; D009584:Nitrogen