Weniger Infektionen, geringere Krankenhausverweildauern - Perioperative Ernährung im Zeitalter der Immunmodulation

Zusammenfassung

Ziel dieser Studie war es, die publizierten und methodisch soliden Arbeiten zur perioperativen Applikation des immunmodulierenden Produktes Impact® bei elektiven Eingriffen zu identifizieren und den Effekt auf die postoperative Morbidität über einen metaanalytischen Ansatz abzuklären. Mithilfe einer Medline-Analyse wurden insgesamt elf randomisierte klinische Studien ausgewählt, bei denen Impact® vor und/oder nach größeren elektiven Eingriffen verabreicht wurde. Zehn der Studien befassten sich mit Patienten mit großen gastrointestinalen Eingriffen. Die primären Endpunkte waren postoperative infektiöse Komplikationen, Mortalität und Hospitalaufenthaltsdauer. Der Einsatz von Impact® war mit einer signifikanten Reduktion an postoperativen Infektionen und der Hospitalaufenthaltsdauer verbunden. Dabei war der Effekt bei peri- und postoperativer Applikation vergleichbar. Ebenfalls festgestellt wurde eine signifikante Reduktion der Anastomoseninsuffizienzen.

Summary

Aim of this study was the examination of the effect of peri- and postoperative supplementation with the immune-modulating product Impact® on postoperative morbidity in patients undergoing elective surgery via meta-analytical approach. Studies were identified through Medline. Eleven randomised clinical trials with IMPACT® given before and/or after major elective surgery and reporting clinical outcome were selected. The primary endpoints were infectious complications, mortality and hospital length of stay (LOS). Ten studies involved patients undergoing gastrointestinal surgery. IMPACT® use was associated with a significant reduction in postoperative infectious complications and a significant decrease in length of stay. Similar results were observed in subgroups with peri- or postoperative application. In GI surgery, anastomotic leaks were significantly reduced under IMPACT®.

Key Words

immunonutrition - perioperative elective surgery - postoperative morbidity - metaanalysis

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