The impact of preoperative oral nutrition supplementation on outcomes in patients undergoing gastrointestinal surgery for cancer in low- and middle-income countries: a systematic review and meta-analysis.
The impact of preoperative oral nutrition supplementation on outcomes in patients undergoing gastrointestinal surgery for cancer in low- and middle-income countries: a systematic review and meta-analysis.
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DOI：
10.1038/s41598-022-16460-4
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发表时间：
2022-07-21
影响因子：
4.6
通讯作者：
Harrison, Ewen M.
中科院分区：
文献类型：
--
作者：
Knight, Stephen R.;Qureshi, Ahmad U.;Drake, Thomas M.;Lapitan, Marie Carmela M.;Maimbo, Mayaba;Yenli, Edwin;Tabiri, Stephen;Ghosh, Dhruva;Kingsley, Pamela A.;Sundar, Sudha;Shaw, Catherine;Valparaiso, Apple P.;Bhangu, Aneel;Brocklehurst, Peter;Magill, Laura;Morton, Dion G.;Norrie, John;Roberts, Tracey E.;Theodoratou, Evropi;Weiser, Thomas G.;Burden, Sorrel;Harrison, Ewen M.
营养不良是中低收入国家(LMIC)术后并发症的独立预测因子。我们系统地回顾了有关术前口服营养补充(ONS)对在LMICs接受胃肠道肿瘤手术的患者的影响的证据。我们检索了EMBASE、Cochrane图书馆、Web of Science、Scope us、WHO Global Index Medicus、SciELO、拉丁美洲和加勒比健康科学文献(Lilacs)数据库，以确定从最初到2022年3月21日的随机对照试验，以评估LMICs内胃肠癌的术前ONS。我们使用随机效应荟萃分析评估了ONS对所有术后结果的影响。7项研究报告了891例胃肠道肿瘤手术患者(ONS组446例，对照组445例)。术前ONS减少了手术并发症(RR0.53，95%CI0.46~0.60，P <； 0.001，I2 = 0%，n = 891)，感染(0.52，0.40~0.67，P = 0.008，I2 = 0%，n = 570)和全因死亡率(0.35，0.26~0.47，P = 0.014，I2 = 0%，n = 588)。尽管人群和基线比率不同，但所有原因的绝对风险比(ARR)都降低了(汇集效应−0.14，−0.22至−0.06，P = 0.006；需要治疗的人数(NNT)7)和感染性并发症(−0.13，−0.22至−0.06，P <； 0.001；NNT 8)。在LMICs接受胃肠道癌症手术的患者的术前营养显示，在测量的结果中，持续强劲的治疗效果。然而，迫切需要更多更高质量的研究，特别是在非洲人口中的研究。
Malnutrition is an independent predictor for postoperative complications in low- and middle-income countries (LMICs). We systematically reviewed evidence on the impact of preoperative oral nutrition supplementation (ONS) on patients undergoing gastrointestinal cancer surgery in LMICs. We searched EMBASE, Cochrane Library, Web of Science, Scopus, WHO Global Index Medicus, SciELO, Latin American and Caribbean Health Sciences Literature (LILACS) databases from inception to March 21, 2022 for randomised controlled trials evaluating preoperative ONS in gastrointestinal cancer within LMICs. We evaluated the impact of ONS on all postoperative outcomes using random-effects meta-analysis. Seven studies reported on 891 patients (446 ONS group, 445 control group) undergoing surgery for gastrointestinal cancer. Preoperative ONS reduced all cause postoperative surgical complications (risk ratio (RR) 0.53, 95% CI 0.46–0.60, P < 0.001, I2 = 0%, n = 891), infection (0.52, 0.40–0.67, P = 0.008, I2 = 0%, n = 570) and all-cause mortality (0.35, 0.26–0.47, P = 0.014, I2 = 0%, n = 588). Despite heterogeneous populations and baseline rates, absolute risk ratio (ARR) was reduced for all cause (pooled effect −0.14, −0.22 to −0.06, P = 0.006; number needed to treat (NNT) 7) and infectious complications (−0.13, −0.22 to −0.06, P < 0.001; NNT 8). Preoperative nutrition in patients undergoing gastrointestinal cancer surgery in LMICs demonstrated consistently strong and robust treatment effects across measured outcomes. However additional higher quality research, with particular focus within African populations, are urgently required.
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影响因子：
15.8
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
3.7
作者：
Noh, Gyoung Tae;Han, Jeonghee;Min, Byung Soh
通讯作者：
Min, Byung Soh
影响因子：
51.1
作者：
Arnold, Melina;Rutherford, Mark J.;Bray, Freddie
通讯作者：
Bray, Freddie
DOI：
10.1016/s0140-6736(17)33326-3
发表时间：
2018-03-17
期刊：
Lancet (London, England)
影响因子：
--
作者：
Allemani C;Matsuda T;Di Carlo V;Harewood R;Matz M;Nikšić M;Bonaventure A;Valkov M;Johnson CJ;Estève J;Ogunbiyi OJ;Azevedo E Silva G;Chen WQ;Eser S;Engholm G;Stiller CA;Monnereau A;Woods RR;Visser O;Lim GH;Aitken J;Weir HK;Coleman MP;CONCORD Working Group
通讯作者：
CONCORD Working Group
DOI：
10.1016/0360-3016(95)00220-s
发表时间：
1995-07-30
影响因子：
7
作者：
PEREZ, CA;GRIGSBY, PW;LOCKETT, MA
通讯作者：
LOCKETT, MA