{Reference Type}: Meta-Analysis
{Title}: Oral care reduces incidence of pneumonia after esophagectomy: systematic review and meta-analysis.
{Author}: Jogiat U;Kirkland M;Verhoeff K;Bédard ELR;Kung JY;Turner SR;
{Journal}: Langenbecks Arch Surg
{Volume}: 408
{Issue}: 1
{Year}: 2023 May 24
{Factor}: 2.895
{DOI}: 10.1007/s00423-023-02936-y
{Abstract}: <B>OBJECTIVE: </B>Post-operative pneumonia after esophagectomy is a major contributor to morbidity and mortality. Prior studies have demonstrated a link between the presence of pathologic oral flora and the development of aspiration pneumonia. The objective of this systematic review and meta-analysis was to evaluate the effect of pre-operative oral care on the incidence of post-operative pneumonia after esophagectomy.<BR><B>METHODS: </B>A systematic search of the literature was performed on September 2, 2022. Screening of titles and abstracts, full-text articles, and evaluation of methodological quality was performed by two authors. Case reports, conference proceedings, and animal studies were excluded. A meta-analysis of peri-operative oral care on the odds of post-operative pneumonia after esophagectomy was performed using Revman 5.4.1 with a Mantel-Haenszel, random-effects model.<BR><B>RESULTS: </B>A total of 736 records underwent title and abstract screening, leading to 28 full-text studies evaluated for eligibility. A total of nine studies met the inclusion criteria and underwent meta-analysis. Meta-analysis revealed a significant reduction in post-operative pneumonia among patients undergoing pre-operative oral care intervention compared to those without an oral care intervention (OR 0.57, 95% CI 0.43-0.74, p < 0.0001; I2 = 49%).<BR><B>CONCLUSIONS: </B>Pre-operative oral care interventions have significant potential in the reduction of post-operative pneumonia after esophagectomy. North American prospective studies, as well as studies on the cost-benefit analysis, are required.