Department of Nutrition & Dietetics, Logan Hospital, Meadowbrook, QLD 4131, Australia.
School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD 4059, Australia.
Nutrients. 2021 Oct 25;13(11):3775. doi: 10.3390/nu13113775.
This systematic review summarises the literature regarding the impact of preoperative dietary interventions on non-bariatric surgery outcomes for patients with excess weight/obesity, a known risk factor for poor surgical outcomes. Four electronic databases were searched for non-bariatric surgery studies that evaluated the surgical outcomes of a preoperative diet that focused on weight/fat loss or improvement of liver steatosis. Meta-analysis was unfeasible due to the extreme heterogeneity of variables. Fourteen studies, including five randomised controlled trials, were selected. Laparoscopic cholecystectomy, hernia repair, and liver resection were most studied. Diet-induced weight loss ranged from 1.4 kg to 25 kg. Preoperative very low calorie diet (≤800 kcal) or low calorie diet (≤900 kcal) for one to three weeks resulted in: reduction in blood loss for two liver resection and one gastrectomy study (-27 to -411 mL, < 0.05), and for laparoscopic cholecystectomy, reduction of six minutes in operating time ( < 0.05) and reduced difficulty of aspects of procedure ( < 0.05). There was no difference in length of stay ( = 7 studies). Preoperative ≤ 900 kcal diets for one to three weeks could improve surgical outcomes for laparoscopic cholecystectomy, liver resection, and gastrectomy. Multiple randomised controlled trials with common surgical outcomes are required to establish impact on other surgeries.
这篇系统综述总结了关于术前饮食干预对超重/肥胖患者非减肥手术结果的影响的文献，超重/肥胖是手术结果不良的已知危险因素。四个电子数据库搜索了评估术前饮食对减肥或改善肝脂肪变性的手术结果的非减肥手术研究。由于变量的极端异质性，无法进行荟萃分析。选择了 14 项研究，包括 5 项随机对照试验。腹腔镜胆囊切除术、疝修补术和肝切除术是研究最多的。饮食诱导的体重减轻范围为 1.4 公斤至 25 公斤。术前极低热量饮食（≤800 千卡）或低热量饮食（≤900 千卡）一至三周可使：两项肝切除术和一项胃切除术的出血量减少（-27 至-411 毫升，<0.05），腹腔镜胆囊切除术的手术时间减少 6 分钟（<0.05），手术过程的难度降低（<0.05）。住院时间无差异（=7 项研究）。一至三周的术前≤900 千卡饮食可能会改善腹腔镜胆囊切除术、肝切除术和胃切除术的手术结果。需要进行具有共同手术结果的多项随机对照试验来确定对其他手术的影响。
