title: Omega-3 polyunsaturated fatty acids in the prevention of postoperative complications in colorectal cancer: a meta-analysis.
abstract: OBJECTIVE
  To evaluate systematically the clinical efficacy of omega-3 polyunsaturated fatty acids (PUFAs) in the prevention of postoperative complications in colorectal cancer (CRC) patients.
  
  
  METHODS
  Published articles were identified by using search terms in online databases - PubMed, Embase, and the Cochrane Library - up to March 2016. Only randomized controlled trials investigating the efficacy of omega-3 PUFAs in CRC were selected and analyzed through a meta-analysis. Subgroup, sensitivity, and inverted funnel-plot analyses were also conducted.
  
  
  RESULTS
  Eleven articles with 694 CRC patients were finally included. Compared with control, omega-3 PUFA-enriched enteral or parenteral nutrition during the perioperative period reduced infectious complications (risk ratio [RR] 0.63, 95% confidence interval [CI] 0.47-0.86;P=0.004), tumor necrosis factor alpha (standard mean difference [SMD] -0.37, 95% CI -0.66 to -0.07;P=0.01), interleukin-6 (SMD -0.36, 95% CI -0.66 to -0.07;P=0.02), and hospital stay (MD -2.09, 95% CI -3.71 to -0.48;P=0.01). No significant difference was found in total complications, surgical site infection, or CD4+:CD8+cell ratio.
  
  
  CONCLUSIONS
  Short-term omega-3 PUFA administration was associated with reduced postoperative infectious complications, inflammatory cytokines, and hospital stay after CRC surgery. Due to heterogeneity and relatively small sample size, the optimal timing and route of administration deserve further study.
authors.affiliation: Department of Emergency, The First Hospital of Lanzhou University.
authors.forename: Hai
authors.initials: H
authors.lastname: Xie
authors.affiliation: Department of Anesthesiology, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, People's Republic of China.
authors.forename: Yan-Na
authors.initials: YN
authors.lastname: Chang
keywords: colorectal surgery; fatty acids; fish oil; meta-analysis; omega-3