Perioperative immunonutrition for gastrointestinal cancer: a systematic review of randomized controlled trials.
BACKGROUND
To improve the clinical outcome, immunonutrition (IN) was usually used in the patients undergoing elective gastrointestinal caner surgery. However, its effectiveness remains uncertain.


METHODS
Randomized controlled trials (RCTs) published between 1995 and 2011 were identified and extracted by two reviewers independently from electronic databases, including PubMed, EMBASE, and Cochrane Library. The quality of included trials was assessed according to the handbook for Cochrane reviewer (V5.0.1). Statistical analysis was carried out with RevMan software.


RESULTS
Nineteen RCTs involving a total of 2331 patients were included in our meta-analysis. The results showed perioperative IN significantly reduced length of hospital stay (WMD, -2.62; 95% CI, -3.26 to -1.97; P < 0.01) and morbidity of postoperative infectious complication (RR, 0.44; 95% CI, 0.32 to 0.60; P < 0.01) compared with standard diet. Moreover, perioperative IN also significantly decreased morbidity of postoperative non-infectious complication in comparison with standard diet (RR, 0.72; 95% CI, 0.54 to 0.97; P = 0.03).


CONCLUSIONS
Perioperative IN is effective and safe to reduce postoperative infection, non-infection complication and length of hospital stay.
Gansu Provincial Hospital, Donggang West Road No. 204, Chengguan District, Lanzhou City, Gansu Province, China.
Yan
Y
Zhang
Yuanhui
Y
Gu
Tiankang
T
Guo
Yiping
Y
Li
Hui
H
Cai
D004750:Enteral Nutrition / Q000379:methods; D005770:Gastrointestinal Neoplasms / Q000601:surgery*; D006801:Humans; D056747:Immunomodulation / Q000502:physiology*; D007239:Infections / Q000178:diet therapy*; D007902:Length of Stay; D018529:Nutritional Support / Q000379:methods*; D010288:Parenteral Nutrition / Q000379:methods; D019990:Perioperative Care; D011183:Postoperative Complications / Q000178:diet therapy / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic