接受膀胱切除术患者的营养康复：系统评价。

Nutritional Prehabilitation in Patients Undergoing Cystectomy: A Systematic Review.

机构信息

Veneto Institute of Oncology IOV-IRCCS, 35128 Padua, Italy.

IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy.

出版信息

Nutrients. 2024 May 29;16(11):1682. doi: 10.3390/nu16111682.

DOI:10.3390/nu16111682

PMID:38892615

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11174884/

Abstract

BACKGROUND/AIM: Nutrition is a key element of the prehabilitation process prior to surgery. The aim of this study was to identify the clinical pathways of nutritional prehabilitation before cystectomy.

METHODS

A systematic literature review was conducted in PubMed, the Cochrane Library, CINAHL, Scopus and the Web of Science databases. Quality and risk of bias assessment was conducted adhering to the JBI framework and evidence was evaluated according to the Oxford Centre for Evidence Based Medicine levels of evidence.

RESULTS

Out of 586 records identified, six studies were included. Among them, only two were randomized controlled trials. Immunonutrition has been shown to improve postoperative bowel function (3.12 vs. 3.74 days; RR 0.82; CI, 0.73-0.93; = 0.0029) and decrease postoperative complications (-36.7%; = 0.008) and readmission rates (-15.38%; = 0.03). Furthermore, oral nutritional supplements combined with nutritional counseling demonstrated an accelerated recovery of bowel function (-1 day; < 0.01), a reduction in the length of hospital stay (-1.75 days; = 0.01), an improvement in handgrip strength (+6.8%, < 0.001), an increase in bone mass (+0.3 kg, = 0.04), and a better BMI value (+2.3%, = 0.001).

CONCLUSIONS

Nutritional prehabilitation demonstrates potential in enhancing postoperative outcomes following radical cystectomy. Oral supplements, immunonutrition, and counseling exhibit efficacy in improving postoperative results.

摘要

背景/目的：营养是手术前康复过程的关键要素。本研究的目的是确定膀胱癌根治术前营养康复的临床路径。

方法

在 PubMed、Cochrane 图书馆、CINAHL、Scopus 和 Web of Science 数据库中进行系统文献检索。根据 JBI 框架进行质量和偏倚风险评估，并根据牛津循证医学中心的证据水平评估证据。

结果

在 586 条记录中，有 6 项研究被纳入。其中，仅有 2 项为随机对照试验。免疫营养可改善术后肠道功能（3.12 天比 3.74 天；RR 0.82；CI，0.73-0.93； = 0.0029），减少术后并发症（-36.7%； = 0.008）和再入院率（-15.38%； = 0.03）。此外，口服营养补充剂联合营养咨询可加速肠道功能恢复（-1 天； < 0.01），缩短住院时间（-1.75 天； = 0.01），提高握力（+6.8%； < 0.001），增加骨量（+0.3kg； = 0.04），改善 BMI 值（+2.3%； = 0.001）。