The effects of enteral immunonutrition in upper gastrointestinal surgery: A systematic review and meta-analysis

Wong, Chee Siong; Aly, Emad H

doi:10.1016/j.ijsu.2016.03.043

Cited by 73 publications

(56 citation statements)

References 33 publications

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“…One meta-analysis that included studies with patients that underwent esophagectomy, gastrectomy and pancreatectomy, demonstrated that patients who received immunonutrition postoperatively, had a significantly lower risk of wound infection and shorter length of hospital stay. No significant effect of immunonutrition on other postoperative morbidities and mortality was noticed [86]. The reduction in hospital stay and/ or in postoperative complications seems to compensate for the higher cost of immunonutrition compared to standard enteral feeding in a cost-effectiveness analysis [87].…”

Section: Esophageal Abnormalitiesmentioning

confidence: 94%

Nutritional Management of Esophageal Cancer Patients

Schizas¹,

Lidoriki²,

Moris³

et al. 2017

Esophageal Abnormalities

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Esophageal cancer is associated with malnutrition in the vast majority of patients. This phenomenon is partly attributed to the disease process itself, the location of the tumor and other factors, such as dysphagia which is often accentuated due to chemotherapy/ radiotherapy treatment or surgical intervention. The poor nutritional status of these patients is often related to the presence of cancer cachexia, altered metabolism, and tissue wasting. Malnutrition in this patient population affects quality of life, worsens patient's tolerance to chemotherapy and accounts for lower survival. Nutritional management of these patients includes both proper nutritional assessment and support and might prevent, to a certain extent, the manifestation of malnutrition-related consequences. The purpose of this article is to review the current literature in order to focus on the etiology and diagnosis of malnutrition in esophageal cancer patients, emphasizing also on the optimal nutritional support during multimodality treatment.

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Section: Esophageal Abnormalitiesmentioning

confidence: 94%

Nutritional Management of Esophageal Cancer Patients

Schizas¹,

Lidoriki²,

Moris³

et al. 2017

Esophageal Abnormalities

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“…In addition, a meta-analysis found that enteral IN significantly reduces the incidence of postoperative infectious complication and the LOH in patients undergoing major elective surgery for gastrointestinal malignances [12]. To date, a systematic review and meta-analysis by Wong and Aly [15] has demonstrated that enteral IN decreases wound infection rates and reduces LOH, and that it should be recommended as routine nutritional support as part of the Enhanced Recovery after Surgery (ERAS ® ) programs for upper gastrointestinal surgery. However, thus far, trials have been conducted in heterogeneous patient groups [16], hampering the establishment of recommendations for specific patient groups.…”

Section: Immunonutrition In Esophagogastric Cancermentioning

confidence: 99%

Effects of Enteral Immunonutrition in Esophageal Cancer

Mimatsu

Fukino

Ogasawara

et al. 2017

Gastrointest Tumors

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Background: Immunonutrition (IN) significantly reduces the incidence of postoperative infectious complications and the length of hospitalization in patients undergoing major elective surgery for gastrointestinal malignances. However, the clinical benefit of IN in patients who have undergone esophagectomy for esophageal cancer is unclear. Moreover, the effect of enteral IN in patients during preoperative adjuvant chemoradiotherapy and in patients treated with concurrent chemoradiotherapy for advanced esophageal cancer is unknown. Summary: This review analyzes the evidence supporting the enteral administration of IN in patients who have undergone esophagectomy and/or chemoradiotherapy for esophageal cancer. Twelve trials that evaluated IN exclusively in patients who underwent esophagectomy were published between January 1980 and August 2017. Two trials concerning IN during chemoradiotherapy for esophageal cancer were identified in the same period. However, the evidence is insufficient to recommend enteral IN in patients who have undergone esophagectomy and/or chemoradiotherapy for esophageal cancer. Key Message: Further evidence from well-designed randomized controlled trials is required to verify the clinical benefits of enteral IN in patients undergoing esophagectomy and/or chemoradiotherapy for esophageal cancer. Practical Implications: Resolvins, which are generated from EPA, are novel anti-inflammatory lipid mediators and may play a key role in the resolution of acute inflammation when IN is supplemented with EPA in patients undergoing severely stressful operations.

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“…For patients without obvious malnutrition, like Mr. Maule, there are no compelling data regarding nutritional supplementation, but it is recommended that enhanced enteral nutrition should be provided during chemo- and radiotherapy treatment [5]. Immune-enteral nutrition may be especially beneficial; pre-operative provision of specialized nutritional support with immune-modulating nutrients reportedly results in less post-operative morbidity and is cost-effective for major operations, including esophagectomy [6]. …”

Section: Physician’s Perspectivementioning

confidence: 99%

Oesophageal Adenocarcinoma: A Patient and Physician’s Perspective

Maule¹,

Boccola

Lord

2017

Oncol Ther

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This article is co-authored by a patient with oesophageal adenocarcinoma and his physician, who performed oesophagectomy. The patient relates his pre-operative preparation and post-operative experience. The physician comments on the alarming increase in the incidence of this cancer, risk factors, and treatment. As illustrated by the patient’s report, the physician also discusses the importance of maintaining adequate nutrition, cardiorespiratory fitness, and a positive psychological attitude.

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The effects of enteral immunonutrition in upper gastrointestinal surgery: A systematic review and meta-analysis

Abstract: Overall, our analysis found that IEN decreases wound infection rates and reduces length of stay. It should be recommended as routine nutritional support as part of the Enhanced Recovery after Surgery (ERAS) programmes for upper GI Surgery.

Cited by 73 publications

References 33 publications

Nutritional Management of Esophageal Cancer Patients

Nutritional Management of Esophageal Cancer Patients

Effects of Enteral Immunonutrition in Esophageal Cancer

Oesophageal Adenocarcinoma: A Patient and Physician’s Perspective

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