Department of General Surgery, China-Japan Friendship Hospital, Beijing, China.
Nutr Cancer. 2021;73(2):252-261. doi: 10.1080/01635581.2020.1749291. Epub 2020 Apr 14.
In this systematic review and meta-analysis, 25 clinical trials were systematically reviewed, and meta-analysis was performed with the results of 16 trials. It was found that the risk of surgical site infection was significantly lower in patients who received perioperative immunonutrition than those given standard nutrition. Furthermore, hospital stay was significantly shorter in patients receiving immunonutrition or early enteral nutrition after surgical resection of gastric cancer. Perioperative immunonutrition also significantly reduced white blood cell counts and the level of C-reactive protein in the patients. However, neither CD4 T cells nor inflammatory cytokines were significantly affected even though immunonutrition was in favor. These findings suggested that patients with gastrointestinal cancer may benefit from perioperative immunonutrition support by reducing surgery-associated complications and shortening hospital stay. The effects and the underlying mechanism of immunonutrition on immunological modulation and inflammatory regulation, however, remain to be further defined.
在这项系统评价和荟萃分析中，系统性地回顾了 25 项临床试验，并对 16 项试验的结果进行了荟萃分析。结果发现，与接受标准营养相比，接受围手术期免疫营养的患者发生手术部位感染的风险显著降低。此外，接受胃癌手术后免疫营养或早期肠内营养的患者住院时间明显缩短。围手术期免疫营养还显著降低了患者的白细胞计数和 C 反应蛋白水平。然而，即使免疫营养有利，CD4 T 细胞或炎症细胞因子也没有受到显著影响。这些发现表明，胃肠道癌症患者可能受益于围手术期免疫营养支持，从而减少与手术相关的并发症和缩短住院时间。然而，免疫营养对免疫调节和炎症调节的作用及其潜在机制仍有待进一步明确。
