The effect of immunonutrition on postoperative ileus following colorectal cancer surgery: a systematic review and meta-analysis of randomized controlled trials
Abstract
Objective: The effect of immunonutrition on postoperative gastrointestinal recovery in patients undergoing colorectal cancer surgery remains controversial. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of immunonutrition in alleviating postoperative ileus following colorectal cancer surgery.
Methods: We searched PubMed, Web of Science, Embase, China National Knowledge Infrastructure, VIP, and Cochrane Library databases for eligible studies. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated.
Results: A total of 28 RCTs involving 2,367 patients were included. Compared with the control group, immunonutrition supplementation significantly shortened the time to first flatus (MD, -0.56 days; 95% CI, -0.74, -0.39, p p = 0.005), and postoperative length of hospital stay (MD, -1.47 days; 95% CI, -2.39, -0.55, p = 0.002). Moreover, immunonutrition reduced the incidence of overall postoperative complications (RR 0.64, 95% CI 0.55, 0.75) and postoperative abdominal distension (RR 0.33, 95% CI 0.12, 0.89).
Conclusion: Perioperative immunonutrition supplementation significantly shortened the time to first flatus and time to first defecation after colorectal cancer surgery. Further large-scale, multicenter RCTs are warranted to confirm these findings and establish optimal supplementation protocols.
Systematic review registration:…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 2,367 participants or records.
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