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Effect of enteral immunonutrition as a nutritional strategy in hospitalized cancer patients undergoing major gastrointestinal surgery: systematic review and meta-analysis

Recoba Obregon P.E.; Gómez Bernal J.; Rivera Andrades G.; Buezo Villena L. · Nutricion Clinica y Dietetica Hospitalaria (2024) · DOI: 10.12873/444recoba

Resumen

Introduction: Oncological patients undergoing gastric or colon surgery with malnutrition may present alterations related to the inflammatory response and post-operative complications. Objective: The aim of the following article is to determine, based on a systematic review with meta-analysis, the effect of enteral immunonutrition (arginine, glutamine, omega-3 and nucleotides) as a nutritional strategy in hospitalised cancer patients undergoing major gastrointestinal surgery to reduce post-operative infectious complications and modify changes in the inflammatory response. Material and Methods: An exhaustive search was conducted in Spanish, English and Portuguese for the Medline databases through Ovid, Cochrane (Central), Scopus, Web of Science, EMBASE, Google Scholar and Trip Data Base. Duplicate filtering was performed by two reviewers using the Rayyan tool and data extraction with risk of bias assessment using the ROB-2 tool. Meta-analyses were performed with fixed effects models and publication bias assessment using funnel plots. Results: 18 international randomised clinical trials (RCTs) (5.5 % developed in the Americas, 50 % in Asia and 44.5 % in Europe) were used for the construction of the systematic review. For enteral immunonutrition compared to standard enteral nutrition a low level of certainty was found for the outcomes of post-operative complications due to infections (RR 0.74 CI 95%; 0.60-0.90, p=0.003; I2=12%, random effects model) in patients with gastric and colon cancer. Conclusions: Enteral immunonutrition may have little to no effect on the occurrence of infectious post-operative complications in the oncology patient with major gastrointestinal surgeries.

Instituciones: Universidad Científica del Sur