PDF(Pubmed)
Abstract：
Initial evidence indicates that preoperatively initiated administration of omega-3 fatty acids (FAs) attenuates the postoperative inflammatory reaction. The effects of immunonutrition containing omega-3 FAs, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on the inflammatory response to abdominal surgery continues to be unclear, although improved outcomes have been reported. Therefore, we determined the effectiveness of preoperatively initiated omega-3 FAs administration on postoperative inflammation defined as CRP (C-Reactive Protein), IL-6 (Interleukin 6), and WBC (White Blood Count) and potential effects on postoperative length of hospital stay (LOS) due to an improved inflammatory response.
METHODS: a literature search of Cochrane Library was conducted to identify all randomized controlled trials (RCTs) investigating the effects of preoperatively initiated omega-3 to standard care, placebo, or other immunonutrients excluding omega-3 FAs in patients undergoing abdominal surgery until the end of December 2022.
RESULTS: a total of 296 articles were found during the initial search. Thirteen RCTs involving 950 patients were identified that met the search criteria. These were successively analyzed and included in this meta-analysis. There was no significant difference between the groups with respect to inflammatory markers IL-6: -0.55 [-1.22; 0.12] p = 0.10, CRP: -0.14 [-0.67; 0.40] p = 0.55, WBC: -0.58 [-3.05; 1.89] p = 0.42, or hospital stay -0.5 [-1.43; 0.41] p = 0.2.
CONCLUSIONS: although reduced inflammatory markers were observed, preoperative administration of omega-3 FAs immunonutrients had no significant effect on the postoperative inflammatory response in patients undergoing abdominal surgeries. Yet, results obtained from this study are inconclusive, likely attributed to the limited number of trials and patients included. Further studies are required to obtain a better educated verdict.
METHODS: a literature search of Cochrane Library was conducted to identify all randomized controlled trials (RCTs) investigating the effects of preoperatively initiated omega-3 to standard care, placebo, or other immunonutrients excluding omega-3 FAs in patients undergoing abdominal surgery until the end of December 2022.
RESULTS: a total of 296 articles were found during the initial search. Thirteen RCTs involving 950 patients were identified that met the search criteria. These were successively analyzed and included in this meta-analysis. There was no significant difference between the groups with respect to inflammatory markers IL-6: -0.55 [-1.22; 0.12] p = 0.10, CRP: -0.14 [-0.67; 0.40] p = 0.55, WBC: -0.58 [-3.05; 1.89] p = 0.42, or hospital stay -0.5 [-1.43; 0.41] p = 0.2.
CONCLUSIONS: although reduced inflammatory markers were observed, preoperative administration of omega-3 FAs immunonutrients had no significant effect on the postoperative inflammatory response in patients undergoing abdominal surgeries. Yet, results obtained from this study are inconclusive, likely attributed to the limited number of trials and patients included. Further studies are required to obtain a better educated verdict.
摘要：
初步证据表明，术前开始施用ω-3脂肪酸（FA）可减轻术后炎症反应。含有omega-3脂肪酸的免疫营养的影响，如二十碳五烯酸（EPA）和二十二碳六烯酸（DHA），关于腹部手术的炎症反应仍然不清楚，尽管据报道结局有所改善。因此,我们确定了术前开始omega-3FAs给药对定义为CRP（C反应蛋白）的术后炎症的有效性，IL-6(白介素6),和WBC（白细胞计数）以及由于炎症反应改善而对术后住院时间（LOS）的潜在影响。
方法：对Cochrane库进行了文献检索，以确定所有研究术前开始的omega-3对标准护理的影响的随机对照试验（RCT）。安慰剂,或其他免疫营养素，不包括在2022年12月底之前接受腹部手术的患者的omega-3FAs。
结果：在最初的搜索过程中，共找到296篇文章。确定了13个RCT，涉及950名患者，符合搜索标准。这些被连续分析并包括在该荟萃分析中。在炎症标志物IL-6：-0.55[-1.22;0.12]p=0.10，CRP：-0.14[-0.67;0.40]p=0.55，WBC：-0.58[-3.05;1.89]p=0.42或住院时间-0.5[-1.43;0.41]p=0.2方面，两组之间没有显着差异。
结论：虽然观察到炎症标志物减少，术前给予omega-3FAs免疫营养素对腹部手术患者术后炎症反应无显著影响.然而，从这项研究中获得的结果是不确定的，可能归因于试验和患者数量有限.需要进一步的研究才能获得更好的教育结论。
方法：对Cochrane库进行了文献检索，以确定所有研究术前开始的omega-3对标准护理的影响的随机对照试验（RCT）。安慰剂,或其他免疫营养素，不包括在2022年12月底之前接受腹部手术的患者的omega-3FAs。
结果：在最初的搜索过程中，共找到296篇文章。确定了13个RCT，涉及950名患者，符合搜索标准。这些被连续分析并包括在该荟萃分析中。在炎症标志物IL-6：-0.55[-1.22;0.12]p=0.10，CRP：-0.14[-0.67;0.40]p=0.55，WBC：-0.58[-3.05;1.89]p=0.42或住院时间-0.5[-1.43;0.41]p=0.2方面，两组之间没有显着差异。
结论：虽然观察到炎症标志物减少，术前给予omega-3FAs免疫营养素对腹部手术患者术后炎症反应无显著影响.然而，从这项研究中获得的结果是不确定的，可能归因于试验和患者数量有限.需要进一步的研究才能获得更好的教育结论。
