Optimal Perioperative Nutrition Therapy for Patients Undergoing Pancreaticoduodenectomy: A Systematic Review with a Component Network Meta-Analysis

Numerous strategies for perioperative nutrition therapy for patients undergoing pancreaticoduodenectomy (PD) have been proposed. This systematic review aimed to summarize the current relevant published randomized controlled trials (RCTs) evaluating different nutritional interventions via a tradition...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Shang-Yu Wang, Yu-Liang Hung, Chih-Chieh Hsu, Chia-Hsiang Hu, Ruo-Yi Huang, Chang-Mu Sung, Yan-Rong Li, Hao-Wei Kou, Ming-Yang Chen, Shih-Chun Chang, Chao-Wei Lee, Chun-Yi Tsai, Keng-Hao Liu, Jun-Te Hsu, Chun-Nan Yeh, Ta-Sen Yeh, Tsann-Long Hwang, Yi-Yin Jan, Miin-Fu Chen
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	pancreaticoduodenectomy network meta-analysis nutrition therapy postoperative pancreatic fistula immunonutrition Nutrition. Foods and food supply TX341-641
Acceso en línea:	https://doaj.org/article/2e4aaddbfd554ce79ebf500ccfe90099
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2e4aaddbfd554ce79ebf500ccfe90099
record_format	dspace
spelling	oai:doaj.org-article:2e4aaddbfd554ce79ebf500ccfe900992021-11-25T18:36:24ZOptimal Perioperative Nutrition Therapy for Patients Undergoing Pancreaticoduodenectomy: A Systematic Review with a Component Network Meta-Analysis10.3390/nu131140492072-6643https://doaj.org/article/2e4aaddbfd554ce79ebf500ccfe900992021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6643/13/11/4049https://doaj.org/toc/2072-6643Numerous strategies for perioperative nutrition therapy for patients undergoing pancreaticoduodenectomy (PD) have been proposed. This systematic review aimed to summarize the current relevant published randomized controlled trials (RCTs) evaluating different nutritional interventions via a traditional network meta-analysis (NMA) and component network meta-analysis (cNMA). EMBASE, MEDLINE, the Cochrane Library, and ClinicalTrials.gov were searched to identify the RCTs. The evaluated nutritional interventions comprised standard postoperative enteral nutrition by feeding tube (Postop-SEN), preoperative enteral feeding (Preop-EN), postoperative immunonutrients (Postop-IM), preoperative oral immunonutrient supplement (Preop-IM), and postoperative total parenteral nutrition (TPN). The primary outcomes were general, infectious, and noninfectious complications; postoperative pancreatic fistula (POPF); and delayed gastric emptying (DGE). The secondary outcomes were mortality and length of hospital stay (LOS). The NMA and cNMA were conducted with a frequentist approach. The results are presented as odds ratios (ORs) and 95% confidence intervals (CIs). Two primary outcomes, infectious complications and POPF, were positively influenced by nutritional interventions. Preop-EN plus Postop-SEN (OR 0.11; 95% CI 0.02~0.72), Preop-IM (OR 0.22; 95% CI 0.08~0.62), and Preop-IM plus Postop-IM (OR 0.11; 95% CI 0.03~0.37) were all demonstrated to be associated with a decrease in infectious complications. Postop-TPN (OR 0.37; 95% CI 0.19~0.71) and Preop-IM plus Postop-IM (OR 0.21; 95% CI 0.06~0.77) were clinically beneficial for the prevention of POPF. While enteral feeding and TPN may decrease infectious complications and POPF, respectively, Preop-IM plus Postop-IM may provide the best clinical benefit for patients undergoing PD, as this approach decreases the incidence of both the aforementioned adverse effects.Shang-Yu WangYu-Liang HungChih-Chieh HsuChia-Hsiang HuRuo-Yi HuangChang-Mu SungYan-Rong LiHao-Wei KouMing-Yang ChenShih-Chun ChangChao-Wei LeeChun-Yi TsaiKeng-Hao LiuJun-Te HsuChun-Nan YehTa-Sen YehTsann-Long HwangYi-Yin JanMiin-Fu ChenMDPI AGarticlepancreaticoduodenectomynetwork meta-analysisnutrition therapypostoperative pancreatic fistulaimmunonutritionNutrition. Foods and food supplyTX341-641ENNutrients, Vol 13, Iss 4049, p 4049 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pancreaticoduodenectomy network meta-analysis nutrition therapy postoperative pancreatic fistula immunonutrition Nutrition. Foods and food supply TX341-641
spellingShingle	pancreaticoduodenectomy network meta-analysis nutrition therapy postoperative pancreatic fistula immunonutrition Nutrition. Foods and food supply TX341-641 Shang-Yu Wang Yu-Liang Hung Chih-Chieh Hsu Chia-Hsiang Hu Ruo-Yi Huang Chang-Mu Sung Yan-Rong Li Hao-Wei Kou Ming-Yang Chen Shih-Chun Chang Chao-Wei Lee Chun-Yi Tsai Keng-Hao Liu Jun-Te Hsu Chun-Nan Yeh Ta-Sen Yeh Tsann-Long Hwang Yi-Yin Jan Miin-Fu Chen Optimal Perioperative Nutrition Therapy for Patients Undergoing Pancreaticoduodenectomy: A Systematic Review with a Component Network Meta-Analysis
description	Numerous strategies for perioperative nutrition therapy for patients undergoing pancreaticoduodenectomy (PD) have been proposed. This systematic review aimed to summarize the current relevant published randomized controlled trials (RCTs) evaluating different nutritional interventions via a traditional network meta-analysis (NMA) and component network meta-analysis (cNMA). EMBASE, MEDLINE, the Cochrane Library, and ClinicalTrials.gov were searched to identify the RCTs. The evaluated nutritional interventions comprised standard postoperative enteral nutrition by feeding tube (Postop-SEN), preoperative enteral feeding (Preop-EN), postoperative immunonutrients (Postop-IM), preoperative oral immunonutrient supplement (Preop-IM), and postoperative total parenteral nutrition (TPN). The primary outcomes were general, infectious, and noninfectious complications; postoperative pancreatic fistula (POPF); and delayed gastric emptying (DGE). The secondary outcomes were mortality and length of hospital stay (LOS). The NMA and cNMA were conducted with a frequentist approach. The results are presented as odds ratios (ORs) and 95% confidence intervals (CIs). Two primary outcomes, infectious complications and POPF, were positively influenced by nutritional interventions. Preop-EN plus Postop-SEN (OR 0.11; 95% CI 0.02~0.72), Preop-IM (OR 0.22; 95% CI 0.08~0.62), and Preop-IM plus Postop-IM (OR 0.11; 95% CI 0.03~0.37) were all demonstrated to be associated with a decrease in infectious complications. Postop-TPN (OR 0.37; 95% CI 0.19~0.71) and Preop-IM plus Postop-IM (OR 0.21; 95% CI 0.06~0.77) were clinically beneficial for the prevention of POPF. While enteral feeding and TPN may decrease infectious complications and POPF, respectively, Preop-IM plus Postop-IM may provide the best clinical benefit for patients undergoing PD, as this approach decreases the incidence of both the aforementioned adverse effects.
format	article
author	Shang-Yu Wang Yu-Liang Hung Chih-Chieh Hsu Chia-Hsiang Hu Ruo-Yi Huang Chang-Mu Sung Yan-Rong Li Hao-Wei Kou Ming-Yang Chen Shih-Chun Chang Chao-Wei Lee Chun-Yi Tsai Keng-Hao Liu Jun-Te Hsu Chun-Nan Yeh Ta-Sen Yeh Tsann-Long Hwang Yi-Yin Jan Miin-Fu Chen
author_facet	Shang-Yu Wang Yu-Liang Hung Chih-Chieh Hsu Chia-Hsiang Hu Ruo-Yi Huang Chang-Mu Sung Yan-Rong Li Hao-Wei Kou Ming-Yang Chen Shih-Chun Chang Chao-Wei Lee Chun-Yi Tsai Keng-Hao Liu Jun-Te Hsu Chun-Nan Yeh Ta-Sen Yeh Tsann-Long Hwang Yi-Yin Jan Miin-Fu Chen
author_sort	Shang-Yu Wang
title	Optimal Perioperative Nutrition Therapy for Patients Undergoing Pancreaticoduodenectomy: A Systematic Review with a Component Network Meta-Analysis
title_short	Optimal Perioperative Nutrition Therapy for Patients Undergoing Pancreaticoduodenectomy: A Systematic Review with a Component Network Meta-Analysis
title_full	Optimal Perioperative Nutrition Therapy for Patients Undergoing Pancreaticoduodenectomy: A Systematic Review with a Component Network Meta-Analysis
title_fullStr	Optimal Perioperative Nutrition Therapy for Patients Undergoing Pancreaticoduodenectomy: A Systematic Review with a Component Network Meta-Analysis
title_full_unstemmed	Optimal Perioperative Nutrition Therapy for Patients Undergoing Pancreaticoduodenectomy: A Systematic Review with a Component Network Meta-Analysis
title_sort	optimal perioperative nutrition therapy for patients undergoing pancreaticoduodenectomy: a systematic review with a component network meta-analysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2e4aaddbfd554ce79ebf500ccfe90099
work_keys_str_mv	AT shangyuwang optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT yulianghung optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT chihchiehhsu optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT chiahsianghu optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT ruoyihuang optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT changmusung optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT yanrongli optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT haoweikou optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT mingyangchen optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT shihchunchang optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT chaoweilee optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT chunyitsai optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT kenghaoliu optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT juntehsu optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT chunnanyeh optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT tasenyeh optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT tsannlonghwang optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT yiyinjan optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis AT miinfuchen optimalperioperativenutritiontherapyforpatientsundergoingpancreaticoduodenectomyasystematicreviewwithacomponentnetworkmetaanalysis
_version_	1718410883268345856

Optimal Perioperative Nutrition Therapy for Patients Undergoing Pancreaticoduodenectomy: A Systematic Review with a Component Network Meta-Analysis

Ejemplares similares