SP5.2.9 Perioperative immunonutrition in reducing the infectious complications in patients undergoing colorectal cancer resections: a meta-analysis of randomized controlled trials

Abstract

Abstract Objective Perioperative nutritional interventions have been reported to improve colorectal rectal cancer surgery outcomes. The objective of this article is to assess the influences of immunonutrition intervention during perioperative period in patients undergoing colorectal cancer resections. Method Meta-analysis was conducted according to the PRISMA guidelines. Systematic search of medical databases like MEBASE, MEDLINE and pubmed was performed to find studies exclusively reporting the perioperative use of immunonutrition in patients undergoing colorectal cancer resections and relevant published randomized, controlled trials (RCT) were shortlisted according to the inclusion criteria. The analysis of the pooled data was done using the RevMan statistical software. Result Ten RCTs on 1218 patients with colorectal cancer fulfilled the inclusion criteria. In the random effects model analysis, the use of perioperative immunonutrition in patients undergoing colorectal cancer resections statistically reduced the risk [odds ratio 0.59, 95% CI (0.35–1.0), z= 1.96, p=0.05] of infectious complications. However, there was significant heterogeneity [Tau2 = 0.35; Chi2= 19.11, df = 9 (P < 0.02; I2 = 53%)] among included studies. The variables of postoperative mortality [odds ratio 2.1, 95% CI (0.33–12.36), z= 0.75, p=0.45] and length of hospitalization [standardized mean difference 0.16, 95% CI (-0.08–0.39), z= 1.31, p=0.19] were statistically similar in patients using immunonutrition or standard conventional perioperative nutrition. Conclusion Perioperative immunonutrition in patients undergoing colorectal resections seems to reduce infectious complications but this study failed to demonstrate its role in reducing the postoperative mortality and length of hospitalization.