UT Health San Antonio Department of Radiation Oncology, San Antonio, Texas, USA.
J BUON. 2021 Jan-Feb;26(1):204-210.
Perioperative enteral nutrition supports are recommended in esophagus cancer patients. Immunonutrition contains immuno-enhancing nutrients in addition to standard formula. These new nutrients are thought to be efficacious in reducing inflammatory response and improving postoperative immune response and they have been proved to be better than standard enteral nutrition in reducing postoperative complications in gastric cancer. However, if it would lead to a better clinical outcome in patients undergoing esophagectomy remains controversial.
A systematic literature search was performed in the online database of PubMed, Medline, EMBASE and Cochrane Library. The relevant studies were screened out of the results by reading titles and abstracts. Then, we read the full-texts to finally confirm the studies included in this meta-analysis.
Six randomized controlled trials having enrolled 638 patients were included in the final analysis. The pooled analysis didn't show statistically significant difference between immunonutrition group and standard nutrition group in reducing postoperative complications.
The postoperative complications are comparable between immunonutrition and the standard enteral nutrition in patients undergoing esophagectomy, but its value in severe malnutrition patients is undetermined, whereas the high tolerance and other advantages brought by the immunonutrition should not be overlooked and need to be further proved.
围手术期肠内营养支持被推荐用于食管癌患者。免疫营养除了标准配方外还含有免疫增强营养素。这些新的营养素被认为能有效减轻炎症反应，改善术后免疫反应，并且已被证明在减少胃癌患者术后并发症方面优于标准肠内营养。然而，它是否能为接受食管癌切除术的患者带来更好的临床结局仍存在争议。
在 PubMed、Medline、EMBASE 和 Cochrane Library 的在线数据库中进行了系统文献检索。通过阅读标题和摘要筛选出结果中的相关研究，然后阅读全文以最终确定纳入本荟萃分析的研究。
最终纳入了 6 项共纳入 638 例患者的随机对照试验进行分析。荟萃分析显示，免疫营养组与标准营养组在降低术后并发症方面无统计学差异。
在接受食管癌切除术的患者中，免疫营养与标准肠内营养在降低术后并发症方面的效果相当，但在严重营养不良患者中的价值尚不确定，而免疫营养带来的高耐受性和其他优势不应被忽视，需要进一步证实。
