Pre-operative vs. peri-operative nutrition supplementation in hepatic resection for cancer: a systematic review

Bartholomew P. McKay, Annabel L. Larder, Vincent Lam

Research output: Contribution to journalReview articleResearchpeer-review

Abstract

Despite improvements in safety of hepatic resection post-operative complications occur in up to a half of patients. A systematic review was undertaken to compare the effect of pre-operative and peri-operative nutritional supplementation on post-operative outcomes in patients undergoing hepatic resection for malignancy. Included studies were identified through a search of PubMed (1966 to November 2016), Embase (1947 to November 2016) and the Cochrane Library (1993 to November 2016). Eleven studies involving a total of 725 patients were included in this systematic review. BCAA supplementation in the pre-operative and peri-operative period was reported to reduce the overall complication rate by 26.9% (P = 0.01) in one cohort study while pre-operative immunonutrition was shown to reduce post-operative ascites by 25.4% (P =0.012) in another cohort study without affecting the overall complication rate. Four further studies on enteral supplementation failed to show a benefit with regards to post-operative complications. Post-operative mortality was unaffected by pre-operative and peri-operative BCAA. Both pre-operative and peri-operative nutritional supplementation have shown promising results regarding the post-operative course of patients undergoing hepatic resection for malignancy. No randomized controlled study exists directly comparing pre-operative and peri-operative nutrition and this needs to be focused on in future research.

LanguageEnglish
Pages179-198
Number of pages20
JournalNutrition and Cancer
Volume71
Issue number2
DOIs
Publication statusPublished - 17 Feb 2019
Externally publishedYes

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Liver Neoplasms
Liver
Cohort Studies
Ascites
PubMed
Libraries
Small Intestine
Neoplasms
Safety
Mortality

Cite this

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title = "Pre-operative vs. peri-operative nutrition supplementation in hepatic resection for cancer: a systematic review",
abstract = "Despite improvements in safety of hepatic resection post-operative complications occur in up to a half of patients. A systematic review was undertaken to compare the effect of pre-operative and peri-operative nutritional supplementation on post-operative outcomes in patients undergoing hepatic resection for malignancy. Included studies were identified through a search of PubMed (1966 to November 2016), Embase (1947 to November 2016) and the Cochrane Library (1993 to November 2016). Eleven studies involving a total of 725 patients were included in this systematic review. BCAA supplementation in the pre-operative and peri-operative period was reported to reduce the overall complication rate by 26.9{\%} (P = 0.01) in one cohort study while pre-operative immunonutrition was shown to reduce post-operative ascites by 25.4{\%} (P =0.012) in another cohort study without affecting the overall complication rate. Four further studies on enteral supplementation failed to show a benefit with regards to post-operative complications. Post-operative mortality was unaffected by pre-operative and peri-operative BCAA. Both pre-operative and peri-operative nutritional supplementation have shown promising results regarding the post-operative course of patients undergoing hepatic resection for malignancy. No randomized controlled study exists directly comparing pre-operative and peri-operative nutrition and this needs to be focused on in future research.",
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Pre-operative vs. peri-operative nutrition supplementation in hepatic resection for cancer : a systematic review. / McKay, Bartholomew P.; Larder, Annabel L.; Lam, Vincent.

In: Nutrition and Cancer, Vol. 71, No. 2, 17.02.2019, p. 179-198.

Research output: Contribution to journalReview articleResearchpeer-review

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