School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan.
Department of Family Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan.
Nutrients. 2020 Sep 12;12(9):2798. doi: 10.3390/nu12092798.
Immunonutrition is administered to improve the outcome of patients with pancreatic cancer undergoing surgery. However, its effect and mechanism of action remain unclear. Therefore, we conducted this systematic review and meta-analysis to assess its effects on postoperative outcome and the immune system. Randomized controlled trials (RCTs) were identified and data extracted by two reviewers independently from electronic databases from their inception to 31 October 2019. The result was expressed as the risk ratio (RR) for categorical variables and mean difference (MD) for continuous variables with 95% confidence intervals (CIs). Six RCTs published from 1999 and 2016, with a total of 368 patients, were included. The results revealed that immunonutrition significantly decreased the rate of infectious complications (RR = 0.47, 95% CI (0.23, 0.94), = 0.03) and the length of hospital stay (MD = -1.90, 95% CI (-3.78, -0.02), = 0.05) by modulating the immune system, especially in preoperative group in subgroup analysis. We therefore recommend that patients with pancreatic cancer undergoing surgery could take the advantage of immunonutrition, especially in the preoperative period.
免疫营养用于改善接受手术治疗的胰腺癌患者的预后。然而，其作用效果和作用机制仍不清楚。因此，我们进行了这项系统评价和荟萃分析，以评估其对术后结局和免疫系统的影响。两位评审员独立地从电子数据库中检索从建库到 2019 年 10 月 31 日发表的随机对照试验（RCT），并提取数据。结果以分类变量的风险比（RR）和连续变量的均数差（MD）表示，95%置信区间（CI）。纳入了 6 项 RCTs，发表时间为 1999 年至 2016 年，共 368 例患者。结果表明，免疫营养通过调节免疫系统，显著降低了感染并发症的发生率（RR=0.47，95%CI（0.23，0.94）， = 0.03）和住院时间（MD=-1.90，95%CI（-3.78，-0.02）， = 0.05），在亚组分析中，尤其在术前组中。因此，我们建议接受手术治疗的胰腺癌患者可受益于免疫营养，尤其在术前阶段。
