Meta-analysis of the impact of preoperative enteral nutrition on the clinical efficacy of patients with colorectal cancer

doi:10.3760/cma.j.cn441417-20250402-17004

Abstract

Abstract:

Objective　To evaluate the impact of preoperative enteral nutrition on the clinical efficacy of patients with colorectal cancer (CRC). Methods　Computerized searches were conducted in PubMed, Web of Science, Cochrane Library, Embase, Ovid, CNKI, Wanfang Database, VIP Database, Chinese Biomedical Literature Database, and Chinese Medical Journal Full-text Database to collect randomized controlled trials on the impact of preoperative enteral nutrition on the clinical efficacy of patients with CRC. The references of the included studies were also traced. Searchs were performed by combining keywords with free words. Search period: from the establishment of the databases to May 2024. A meta-analysis was conducted using RevMan 5.4.1 software. Results A total of 13 articles were included. The results of the meta-analysis showed that preoperative enteral nutrition increased the albumin level in CRC patients [MD=1.40, 95%CI: (0.46, 2.35), P<0.05]. Preoperative enteral nutrition increased the prealbumin level in CRC patients [MD=0.02, 95%CI: (0.01, 0.03), P<0.05]. Preoperative enteral nutrition increased the transferrin level in CRC patients [MD=0.27, 95%CI: (0.20, 0.35), P<0.05]. Preoperative enteral nutrition improved the total protein level in CRC patients [MD=-14.74, 95%CI: (-27.49, -2.00), P=0.02]. Preoperative enteral nutrition increased the hemoglobin level in CRC patients [MD=6.01, 95%CI: (3.71, 8.32), P<0.05]. Preoperative enteral nutrition increased the level of immunoglobulin A (IgA) in CRC patients [MD=0.13, 95%CI: (0.03, 0.23), P=0.01]. Preoperative enteral nutrition increased the IgG level in CRC patients [MD=1.10, 95%CI: (0.65, 1.54), P<0.05]. Preoperative enteral nutrition increased the IgM level in CRC patients [MD=0.13, 95%CI: (0.07, 0.20), P<0.05]. Preoperative enteral nutrition reduced the level of interleukin-6 (IL-6) in CRC patients [MD=-10.84, 95%CI: (-15.08, -6.59), P<0.05]. Preoperative enteral nutrition improved lymphocyte levels [MD=0.26, 95%CI: (0.20, 0.32), P<0.05]. Preoperative enteral nutrition reduced the C-reactive protein level in CRC patients [MD=-3.91, 95%CI: (-6.78, -1.04), P<0.05]. Preoperative enteral nutrition reduced the overall incidence of complications [OR=0.52, 95%CI: (0.36, 0.76), P<0.05]. Preoperative enteral nutrition reduced the incidence of postoperative infectious complications [OR=0.39, 95%CI: (0.26, 0.58), P<0.05]. Preoperative enteral nutrition shortened the postoperative hospital stay of CRC patients [MD=-3.04, 95%CI: (-3.36, -2.72), P<0.05]. Preoperative enteral nutrition shortened the time to the first postoperative flatus expulsion [MD=-10.58, 95%CI: (-14.00, -7.17), P<0.05]. There were no statistically significant differences in the time of the first bowel movement after the surgery and in the grip strength [MD=-23.41, 95%CI: (-50.28, 3.45), P=0.09; MD=1.97, 95%CI: (-0.34, 4.28), P=0.09]. Conclusion Preoperative enteral nutrition can improve the nutritional status of CRC patients, regulate immune function, reduce complications and promote postoperative recovery, but its effects on the first postoperative defecation time and grip strength are limited.

Key words:

Colorectal cancer, Preoperative, Enteral nutrition, Clinical efficacy, Meta-analysis

摘要：

目的　评价术前肠内营养对结直肠癌（CRC）患者临床疗效的影响。方法　计算机检索PubMed、Web of Science、Cochrane Library、Embase、Ovid、中国知网、万方数据库、维普数据库、中国生物医学文献数据库及中华医学期刊全文数据库，搜集有关术前肠内营养对CRC患者临床疗效影响的随机对照试验，并追溯纳入研究的参考文献。采用主题词结合自由词方式检索。检索时限：建库至2024年5月。采用RevMan 5.4.1软件进行meta分析。结果　共纳入13篇文献。Meta分析结果显示，术前肠内营养提升CRC患者白蛋白水平［MD=1.40，95%CI：（0.46，2.35），P<0.05］。术前肠内营养提升CRC患者前白蛋白水平［MD=0.02，95%CI：（0.01，0.03），P<0.05］。术前肠内营养提升CRC患者转铁蛋白水平［MD=0.27，95%CI：（0.20，0.35），P<0.05］。术前肠内营养改善CRC患者总蛋白水平［MD=-14.74，95%CI：（-27.49，-2.00），P=0.02］。术前肠内营养提升CRC患者血红蛋白水平［MD=6.01，95%CI：（3.71，8.32），P<0.05］。术前肠内营养提升CRC患者免疫球蛋白A（IgA）水平［MD=0.13，95%CI：（0.03，0.23），P=0.01］。术前肠内营养提升CRC患者IgG水平［MD=1.10，95%CI：（0.65，1.54），P<0.05］。术前肠内营养提升CRC患者IgM水平［MD=0.13，95%CI：（0.07，0.20），P<0.05］。术前肠内营养降低CRC患者白细胞介素-6（IL-6）水平［MD=-10.84，95%CI：（-15.08，-6.59），P<0.05］。术前肠内营养改善淋巴细胞水平［MD=0.26，95%CI：（0.20，0.32），P<0.05］。术前肠内营养降低CRC患者C反应蛋白水平［MD=-3.91，95%CI：（-6.78，-1.04），P<0.05］。术前肠内营养降低总并发症发生率［OR=0.52，95%CI：（0.36，0.76），P<0.05］。术前肠内营养降低术后感染性并发症发生率［OR=0.39，95%CI：（0.26，0.58），P<0.05］。术前肠内营养缩短CRC患者术后住院时间［MD=-3.04，95%CI：（-3.36，-2.72），P<0.05］。术前肠内营养缩短术后首次排气时间［MD=-10.58，95%CI：（-14.00，-7.17），P<0.05］。术后首次排便时间及握力差异均无统计学意义［MD=-23.41，95%CI：（-50.28，3.45），P=0.09；MD=1.97，95%CI：（-0.34，4.28），P=0.09］。结论　术前肠内营养可改善CRC患者营养状况、调节免疫功能、减少并发症并促进术后恢复，但对术后首次排便时间及握力的效果有限。

关键词:

结直肠癌, 术前, 肠内营养, 临床疗效, Meta分析

Tan Shiyong, Lin Haiyang, Hao Yanping, Zi Qinglan, Li Yumei, Huang Haiqun.

Meta-analysis of the impact of preoperative enteral nutrition on the clinical efficacy of patients with colorectal cancer [J]. International Medicine and Health Guidance News, 2025, 31(17): 2835-2842.

谭诗泳林海洋郝燕萍资青兰黎玉梅黄海群.

术前肠内营养对结直肠癌患者临床疗效的影响meta分析 [J]. 国际医药卫生导报, 2025, 31(17): 2835-2842.

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