Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery

Objectives Perioperative nutrition aims to replenish nutritional stores before surgery and reduce postoperative complications. ‘Immunonutrition’ (including omega-3 fatty acids) may modulate the immune system and attenuate the postoperative inflammatory response. Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Michael Scott [verfasserIn] Timothy Rockall [verfasserIn] Martin Brunel Whyte [verfasserIn] Daniel White [verfasserIn] Jason George [verfasserIn] Barbara Fielding [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Übergeordnetes Werk:	In: BMJ Surgery, Interventions, & Health Technologies - BMJ Publishing Group, 2019, 5(2023), 1
Übergeordnetes Werk:	volume:5 ; year:2023 ; number:1

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1136/bmjsit-2022-000172

Katalog-ID:	DOAJ097943339

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520			\|a Objectives Perioperative nutrition aims to replenish nutritional stores before surgery and reduce postoperative complications. ‘Immunonutrition’ (including omega-3 fatty acids) may modulate the immune system and attenuate the postoperative inflammatory response. Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333.
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allfields	10.1136/bmjsit-2022-000172 doi (DE-627)DOAJ097943339 (DE-599)DOAJd755c239aa044b6b815ea18654e338c7 DE-627 ger DE-627 rakwb eng R855-855.5 RD1-811 Michael Scott verfasserin aut Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Perioperative nutrition aims to replenish nutritional stores before surgery and reduce postoperative complications. ‘Immunonutrition’ (including omega-3 fatty acids) may modulate the immune system and attenuate the postoperative inflammatory response. Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333. Medical technology Surgery Timothy Rockall verfasserin aut Martin Brunel Whyte verfasserin aut Daniel White verfasserin aut Jason George verfasserin aut Barbara Fielding verfasserin aut In BMJ Surgery, Interventions, & Health Technologies BMJ Publishing Group, 2019 5(2023), 1 (DE-627)166618621X (DE-600)2973060-0 26314940 nnns volume:5 year:2023 number:1 https://doi.org/10.1136/bmjsit-2022-000172 kostenfrei https://doaj.org/article/d755c239aa044b6b815ea18654e338c7 kostenfrei https://sit.bmj.com/content/5/1/e000172.full kostenfrei https://doaj.org/toc/2631-4940 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2023 1
spelling	10.1136/bmjsit-2022-000172 doi (DE-627)DOAJ097943339 (DE-599)DOAJd755c239aa044b6b815ea18654e338c7 DE-627 ger DE-627 rakwb eng R855-855.5 RD1-811 Michael Scott verfasserin aut Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Perioperative nutrition aims to replenish nutritional stores before surgery and reduce postoperative complications. ‘Immunonutrition’ (including omega-3 fatty acids) may modulate the immune system and attenuate the postoperative inflammatory response. Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333. Medical technology Surgery Timothy Rockall verfasserin aut Martin Brunel Whyte verfasserin aut Daniel White verfasserin aut Jason George verfasserin aut Barbara Fielding verfasserin aut In BMJ Surgery, Interventions, & Health Technologies BMJ Publishing Group, 2019 5(2023), 1 (DE-627)166618621X (DE-600)2973060-0 26314940 nnns volume:5 year:2023 number:1 https://doi.org/10.1136/bmjsit-2022-000172 kostenfrei https://doaj.org/article/d755c239aa044b6b815ea18654e338c7 kostenfrei https://sit.bmj.com/content/5/1/e000172.full kostenfrei https://doaj.org/toc/2631-4940 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2023 1
allfields_unstemmed	10.1136/bmjsit-2022-000172 doi (DE-627)DOAJ097943339 (DE-599)DOAJd755c239aa044b6b815ea18654e338c7 DE-627 ger DE-627 rakwb eng R855-855.5 RD1-811 Michael Scott verfasserin aut Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Perioperative nutrition aims to replenish nutritional stores before surgery and reduce postoperative complications. ‘Immunonutrition’ (including omega-3 fatty acids) may modulate the immune system and attenuate the postoperative inflammatory response. Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333. Medical technology Surgery Timothy Rockall verfasserin aut Martin Brunel Whyte verfasserin aut Daniel White verfasserin aut Jason George verfasserin aut Barbara Fielding verfasserin aut In BMJ Surgery, Interventions, & Health Technologies BMJ Publishing Group, 2019 5(2023), 1 (DE-627)166618621X (DE-600)2973060-0 26314940 nnns volume:5 year:2023 number:1 https://doi.org/10.1136/bmjsit-2022-000172 kostenfrei https://doaj.org/article/d755c239aa044b6b815ea18654e338c7 kostenfrei https://sit.bmj.com/content/5/1/e000172.full kostenfrei https://doaj.org/toc/2631-4940 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2023 1
allfieldsGer	10.1136/bmjsit-2022-000172 doi (DE-627)DOAJ097943339 (DE-599)DOAJd755c239aa044b6b815ea18654e338c7 DE-627 ger DE-627 rakwb eng R855-855.5 RD1-811 Michael Scott verfasserin aut Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Perioperative nutrition aims to replenish nutritional stores before surgery and reduce postoperative complications. ‘Immunonutrition’ (including omega-3 fatty acids) may modulate the immune system and attenuate the postoperative inflammatory response. Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333. Medical technology Surgery Timothy Rockall verfasserin aut Martin Brunel Whyte verfasserin aut Daniel White verfasserin aut Jason George verfasserin aut Barbara Fielding verfasserin aut In BMJ Surgery, Interventions, & Health Technologies BMJ Publishing Group, 2019 5(2023), 1 (DE-627)166618621X (DE-600)2973060-0 26314940 nnns volume:5 year:2023 number:1 https://doi.org/10.1136/bmjsit-2022-000172 kostenfrei https://doaj.org/article/d755c239aa044b6b815ea18654e338c7 kostenfrei https://sit.bmj.com/content/5/1/e000172.full kostenfrei https://doaj.org/toc/2631-4940 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2023 1
allfieldsSound	10.1136/bmjsit-2022-000172 doi (DE-627)DOAJ097943339 (DE-599)DOAJd755c239aa044b6b815ea18654e338c7 DE-627 ger DE-627 rakwb eng R855-855.5 RD1-811 Michael Scott verfasserin aut Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objectives Perioperative nutrition aims to replenish nutritional stores before surgery and reduce postoperative complications. ‘Immunonutrition’ (including omega-3 fatty acids) may modulate the immune system and attenuate the postoperative inflammatory response. Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333. Medical technology Surgery Timothy Rockall verfasserin aut Martin Brunel Whyte verfasserin aut Daniel White verfasserin aut Jason George verfasserin aut Barbara Fielding verfasserin aut In BMJ Surgery, Interventions, & Health Technologies BMJ Publishing Group, 2019 5(2023), 1 (DE-627)166618621X (DE-600)2973060-0 26314940 nnns volume:5 year:2023 number:1 https://doi.org/10.1136/bmjsit-2022-000172 kostenfrei https://doaj.org/article/d755c239aa044b6b815ea18654e338c7 kostenfrei https://sit.bmj.com/content/5/1/e000172.full kostenfrei https://doaj.org/toc/2631-4940 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 5 2023 1
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Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333.</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medical technology</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Surgery</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Timothy Rockall</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Martin Brunel Whyte</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Daniel White</subfield><subfield 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callnumber-first	R - Medicine
author	Michael Scott
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topic_title	R855-855.5 RD1-811 Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery
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title	Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery
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title_full	Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery
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author_browse	Michael Scott Timothy Rockall Martin Brunel Whyte Daniel White Jason George Barbara Fielding
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title_sort	systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery
callnumber	R855-855.5
title_auth	Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery
abstract	Objectives Perioperative nutrition aims to replenish nutritional stores before surgery and reduce postoperative complications. ‘Immunonutrition’ (including omega-3 fatty acids) may modulate the immune system and attenuate the postoperative inflammatory response. Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333.
abstractGer	Objectives Perioperative nutrition aims to replenish nutritional stores before surgery and reduce postoperative complications. ‘Immunonutrition’ (including omega-3 fatty acids) may modulate the immune system and attenuate the postoperative inflammatory response. Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333.
abstract_unstemmed	Objectives Perioperative nutrition aims to replenish nutritional stores before surgery and reduce postoperative complications. ‘Immunonutrition’ (including omega-3 fatty acids) may modulate the immune system and attenuate the postoperative inflammatory response. Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333.
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title_short	Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery
url	https://doi.org/10.1136/bmjsit-2022-000172 https://doaj.org/article/d755c239aa044b6b815ea18654e338c7 https://sit.bmj.com/content/5/1/e000172.full https://doaj.org/toc/2631-4940
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author2	Timothy Rockall Martin Brunel Whyte Daniel White Jason George Barbara Fielding
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up_date	2024-07-03T14:35:20.307Z
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Hitherto, immunonutrition has overwhelmingly been administered in the postoperative period—however, this may be too late to provide benefit.Design A systematic literature search using MEDLINE and EMBASE for randomized controlled trials (RCTs).Setting Perioperative major gastrointestinal surgery.Participants Patients undergoing major gastrointestinal surgery.Interventions Omega-3 fatty acid supplementation commenced in the preoperative period, with or without continuation into postoperative period.Main outcome measures The effect of preoperative omega-3 fatty acids on inflammatory response and clinical outcomes.Results 833 studies were identified. After applying inclusion and exclusion criteria, 12 RCTs, involving 1456 randomized patients, were included. Ten articles exclusively enrolled patients with cancer. Seven studies used a combination of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) as the intervention and five studies used EPA alone. Eight out of 12 studies continued preoperative nutritional support into the postoperative period.Of the nine studies reporting mortality, no difference was seen. Duration of hospitalisation ranged from 4.5 to 18 days with intervention and 3.5 to 23.5 days with control. Omega-3 fatty acids had no effect on postoperative C-reactive protein and the effect on cytokines (including tumor necrosis factor-α, interleukin (IL)-6 and IL-10) was inconsistent. Ten of the 12 studies had low risk of bias, with one study having moderate bias from allocation and blinding.Conclusions There is insufficient evidence to support routine preoperative omega-3 fatty acid supplementation for major gastrointestinal surgery, even when this is continued after surgery.PROSPERO registration number CRD42018108333.</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Medical technology</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Surgery</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Timothy Rockall</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Martin Brunel Whyte</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Daniel White</subfield><subfield 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Systematic review of preoperative n-3 fatty acids in major gastrointestinal surgery

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