TY - JOUR
T1 - The impact of preoperative oral nutrition supplementation on outcomes in patients undergoing gastrointestinal surgery for cancer in low- and middle-income countries
T2 - a systematic review and meta-analysis
AU - Knight, Stephen R.
AU - Qureshi, Ahmad U.
AU - Drake, Thomas M.
AU - Lapitan, Marie Carmela M.
AU - Maimbo, Mayaba
AU - Yenli, Edwin
AU - Tabiri, Stephen
AU - Ghosh, Dhruva
AU - Kingsley, Pamela A.
AU - Sundar, Sudha
AU - Shaw, Catherine
AU - Valparaiso, Apple P.
AU - Bhangu, Aneel
AU - Brocklehurst, Peter
AU - Magill, Laura
AU - Morton, Dion G.
AU - Norrie, John
AU - Roberts, Tracey E.
AU - Theodoratou, Evropi
AU - Weiser, Thomas G.
AU - Burden, Sorrel
AU - Harrison, Ewen M.
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Malnutrition is an independent predictor for postoperative complications in low- and middle-income countries (LMICs). We systematically reviewed evidence on the impact of preoperative oral nutrition supplementation (ONS) on patients undergoing gastrointestinal cancer surgery in LMICs. We searched EMBASE, Cochrane Library, Web of Science, Scopus, WHO Global Index Medicus, SciELO, Latin American and Caribbean Health Sciences Literature (LILACS) databases from inception to March 21, 2022 for randomised controlled trials evaluating preoperative ONS in gastrointestinal cancer within LMICs. We evaluated the impact of ONS on all postoperative outcomes using random-effects meta-analysis. Seven studies reported on 891 patients (446 ONS group, 445 control group) undergoing surgery for gastrointestinal cancer. Preoperative ONS reduced all cause postoperative surgical complications (risk ratio (RR) 0.53, 95% CI 0.46–0.60, P < 0.001, I2 = 0%, n = 891), infection (0.52, 0.40–0.67, P = 0.008, I2 = 0%, n = 570) and all-cause mortality (0.35, 0.26–0.47, P = 0.014, I2 = 0%, n = 588). Despite heterogeneous populations and baseline rates, absolute risk ratio (ARR) was reduced for all cause (pooled effect −0.14, −0.22 to −0.06, P = 0.006; number needed to treat (NNT) 7) and infectious complications (−0.13, −0.22 to −0.06, P < 0.001; NNT 8). Preoperative nutrition in patients undergoing gastrointestinal cancer surgery in LMICs demonstrated consistently strong and robust treatment effects across measured outcomes. However additional higher quality research, with particular focus within African populations, are urgently required.
AB - Malnutrition is an independent predictor for postoperative complications in low- and middle-income countries (LMICs). We systematically reviewed evidence on the impact of preoperative oral nutrition supplementation (ONS) on patients undergoing gastrointestinal cancer surgery in LMICs. We searched EMBASE, Cochrane Library, Web of Science, Scopus, WHO Global Index Medicus, SciELO, Latin American and Caribbean Health Sciences Literature (LILACS) databases from inception to March 21, 2022 for randomised controlled trials evaluating preoperative ONS in gastrointestinal cancer within LMICs. We evaluated the impact of ONS on all postoperative outcomes using random-effects meta-analysis. Seven studies reported on 891 patients (446 ONS group, 445 control group) undergoing surgery for gastrointestinal cancer. Preoperative ONS reduced all cause postoperative surgical complications (risk ratio (RR) 0.53, 95% CI 0.46–0.60, P < 0.001, I2 = 0%, n = 891), infection (0.52, 0.40–0.67, P = 0.008, I2 = 0%, n = 570) and all-cause mortality (0.35, 0.26–0.47, P = 0.014, I2 = 0%, n = 588). Despite heterogeneous populations and baseline rates, absolute risk ratio (ARR) was reduced for all cause (pooled effect −0.14, −0.22 to −0.06, P = 0.006; number needed to treat (NNT) 7) and infectious complications (−0.13, −0.22 to −0.06, P < 0.001; NNT 8). Preoperative nutrition in patients undergoing gastrointestinal cancer surgery in LMICs demonstrated consistently strong and robust treatment effects across measured outcomes. However additional higher quality research, with particular focus within African populations, are urgently required.
UR - http://www.scopus.com/inward/record.url?scp=85134544703&partnerID=8YFLogxK
U2 - 10.1038/s41598-022-16460-4
DO - 10.1038/s41598-022-16460-4
M3 - Article
C2 - 35864290
AN - SCOPUS:85134544703
SN - 2045-2322
VL - 12
JO - Scientific Reports
JF - Scientific Reports
IS - 1
M1 - 12456
ER -
