Meta?analysis on the prognosis of preoperative glucose pretreatment in patients with digestive tract malignant tumor
10.3760/cma.j.issn.1008-6315.2018.01.013
- VernacularTitle:术前糖预处理消化道恶性肿瘤手术患者预后的Meta分析
- Author:
Yahui JIANG
1
;
Yaxu WANG
;
Haitao GU
;
Zan OUYANG
Author Information
1. 400010,重庆医科大学附属第二医院胃肠肛肠外科
- Keywords:
Malignant tumor of digestive tract;
Perioperative period;
Glucose pretreatment;
Meta analysis;
Accelerated rehabilitation surgery
- From:
Clinical Medicine of China
2018;34(1):64-70
- CountryChina
- Language:Chinese
-
Abstract:
Objective The clinical benefits of carbohydrate intake 2-3 h before surgery in patients with digestive tract malignant tumor without diabetes mellitus have been confirmed by foreign experts,the"High level evidence" for perioperative nutrition support were also written in China"Guidelines for perioperative nutritional support in adults".However,there are few hospitals in China that prefer preoperative glucose pretreatment,taking into account the differences between domestic and foreign data.In this paper,the clinical randomly controlled experimental data about the effect of preoperative glucose pretreatment on the prognosis of patients with malignant tumor of digestive tract was analyzed by Meta analysis,in order to evaluate the efficacy and safety of preoperative glucose pretreatment in Chinese patients,and to achieve the clinical significance.Methods Retrieving the database from establishment to March 2017,the related literatures about preoperative glucose pretreatment and prognosis of patients with digestive tract malignant tumor were collected.Revman5.3 software was used to perform Meta analysis of 10 randomized controlled trials(606 patients)who met the inclusion criteria.Results Compared with the traditional fasting and non drinking group,the preoperative subjective discomfort of the preoperative group was significantly reduced(SMD = -1.29,95%CI = -2.00--0.59,P = 0.000 3), postoperative insulin resistance was significantly reduced(SMD=-1.92,95%CI=-2.68--1.16,P<0.01), postoperative blood glucose concentration,insulin concentration increased,and no vomiting and aspiration occur in any patient as shown by the literature.Conclusion In the patients with malignant tumor of digestive tract, perioperative nutrition support and pretreatment show significant clinical benefits,preoperative subjective comfort improves,the risk of aspiration does not increase significantly,postoperative insulin resistance decreases.It is proved that preoperative carbohydrate pretreatment is effective and safe in the operation of domestic digestive tract cancer.
