Modesti Claudia Lodovica, Mattavelli Davide, Testa Gabriele, Tofani Lorenzo, Piazza Cesare
Unit of Otorhinolaryngology - Head and Neck Surgery, ASST Spedali Civili di Brescia, Brescia, Italy.
Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
Acta Otorhinolaryngol Ital. 2025 Apr;45(2):75-83. doi: 10.14639/0392-100X-N3140.
Malnutrition is common among patients undergoing surgery for head and neck cancer (HNC), leading to higher postoperative complications and mortality rates. Immunonutritional intervention has potential in reducing these risks by enhancing immune function and aiding wound healing.
A systematic review and meta-analysis were conducted according to PRISMA guidelines. Nineteen randomised controlled trials involving 1,196 participants undergoing surgery for HNC were included. Studies comparing immunonutrition with standard care were analysed for outcomes including fistula formation, wound infections, other infections, and length of hospital stay.
Immunonutrition significantly reduced postoperative fistulas and shortened hospital stays compared to standard care. The impact on wound and systemic infections was inconclusive. Immunonutrition was generally well-tolerated, with no significant increase in adverse events.
These findings highlight the potential benefits of immunonutrition in improving postoperative outcomes for patients with HNC. However, the variability in study outcomes and limitations in quality call for further research to clarify the specific efficacy, long-term effects, and cost-effectiveness of immunonutrition in this context.
营养不良在接受头颈癌（HNC）手术的患者中很常见，会导致更高的术后并发症和死亡率。免疫营养干预有可能通过增强免疫功能和促进伤口愈合来降低这些风险。
根据PRISMA指南进行系统评价和荟萃分析。纳入了19项随机对照试验，涉及1196例接受HNC手术的参与者。分析比较免疫营养与标准护理的研究的结果，包括瘘管形成、伤口感染、其他感染和住院时间。
与标准护理相比，免疫营养显著减少了术后瘘管的发生，并缩短了住院时间。对伤口和全身感染的影响尚无定论。免疫营养总体耐受性良好，不良事件没有显著增加。
这些发现突出了免疫营养在改善HNC患者术后结局方面的潜在益处。然而，研究结果的变异性和质量限制要求进一步研究，以阐明免疫营养在这种情况下的具体疗效、长期影响和成本效益。
