Effects of Immunomodulatory Nutritional Therapy in cancer patients who have undergone gastrointestinal surgery: a scoping review

Authors

DOI:

https://doi.org/10.33448/rsd-v11i7.29349

Keywords:

Surgical Oncology; Stomach Neoplasms; Nutritional therapy; Immunomodulation.

Abstract

Introduction: Malnutrition represents a determining factor in the clinical outcome of surgical patients, since it can negatively influence the postoperative period, favoring the onset of complications such as delayed wound healing, infections, increased hospital stay, and consequently, mortality. Gastrointestinal tract surgeries in oncologic patients present high rates of complications and morbidity and mortality. Immunomodulatory nutritional therapy has been frequently used in these patients for its high potential to modulate immune activity, often contributing to the improvement of immune function and, consequently, favoring the clinical evolution. Method: This is a scoping review that will take place from September 2021 to January 2022. Studies in English and Portuguese were reviewed, and the databases selected for the search were Latin American and Caribbean Health Sciences Literature (LILACS), MEDLINE/PUBMED, plus gray literature. Results: Thirty-eight potentially eligible publications were identified, and the final sample consisted of 11 studies that evaluated the clinical outcome of cancer patients who received immunomodulatory nutritional therapy in the perioperative period of gastrointestinal surgery. Conclusion: The studies have shown that offering immunomodulatory formulas orally or enterally to cancer patients who have undergone gastrointestinal surgery has brought benefits, reducing complications such as infections and length of stay and providing better results in albumin level as well as in relation to immune function, raising the quality of life of patients. Some points such as mortality and T-lymphocyte increase could not be proven, suggesting that further studies should be conducted.

References

Adamah, A., Skorepa, P., Weimann, A., & Lobo, DN (2019). O impacto da nutrição imunomoduladora pré-operatória nos resultados em pacientes submetidos à cirurgia para câncer gastrointestinal: uma revisão sistemática e meta-análise. Annals of surgery, 270 (2), 247-256. DOI: https://10.1097/SLA.0000000000003256

Arends, J., Bachmann, P., Baracos, V., Barthelemy, N., Bertz, H., Bozzetti, F., ... & Preiser, JC (2017). Diretrizes da ESPEN sobre nutrição em pacientes com câncer. Nutrição clínica, 36 (1), 11-48. DOI: http://dx.doi.org/10.1016/j.clnu.2016.07.015

Au, P. C. M., Li, H. L., Lee, G. K. Y., Li, G. H. Y., Chan, M., Cheung, B. M. Y., & Cheung, C. L. (2021). Sarcopenia and mortality in cancer: A meta-analysis. Osteoporosis and sarcopenia, 7, S28-S33. DOI: https://doi.org/10.1016/j.afos.2021.03.002

Barbosa L. B. G., Fortes R. C., Toscano B. A. F. (2013). Efeitos da imunonutrição em pacientes com câncer do trato gastrintestinal: um ensaio clínico randomizado cego e controlado. Ver. Bras. Nutr. Clin; 2013; 28 (3): 171-8.

Bistrian, BR (2020). O papel da nutrição imunomoduladora pré-operatória. Cirurgia hepatobiliar e nutrição, 9 (2), 221. DOI: http://dx.doi.org/10.21037/hbsn.2019.09.16

Braga M., Gianotti L., Radaelii G., Vignali A., Mari G., Gentilini O., di Carlo V. (1999) Perioperative Immunonutrition in Patients Undergoing Cancer Surgery. JAMA network ARCH SURG/VOL. 134; 428-433. DOI: http://doi.10.1001/archsurg.134.4.428

Braga, M., Gianotti, L., Nespoli, L., Radaelli, G., & Di Carlo, V. (2002). Nutritional approach in malnourished surgical patients: a prospective randomized study. Archives of surgery, 137(2), 174-180. DOI: http://doi:10.1001/archsurg.137.2.174

Carmo S. G., Fontes R. C. (2019). Efeitos do uso de fórmulas imunomoduladoras em pacientes cirúrgicos portadores de câncer do trato gastrintestinal. Ver. Cient. Sena Aires Jan-Mar; 8(1): 96-111. Disponível http://revistafacesa.senaaires.com.br/index.php/revisa/article/view/350

de Oliveira, I. R. S, Andrade, G. D, & de Souza, LP (2021). Desafios do fisioterapeuta nas repercussões disponíveis em pacientes acometidos pelo COVID-19: Protocolo de scoping review. Pesquisa, Sociedade e Desenvolvimento, 10 (7), e4910716032-e4910716032. DOI: https://doi.org/10.33448/rsd-v10i7.16032

D'Ignazio, A., Kabata, P., Ambrosio, M. R., Polom, K., Marano, L., Spagnoli, L., ... & Roviello, F. (2020). Preoperative oral immunonutrition in gastrointestinal surgical patients: How the tumour microenvironment can be modified. Clinical Nutrition ESPEN, 38, 153-159. DOI: https://doi.org/10.1016/j.clnesp.2020.05.012.

Ferraz, L. F., & Campos, A. C. (2012). Nutrição imunomoduladora pré-operatória em pacientes com câncer gástrico. Nutr Clín Diet Hosp, 32(3), 43-6. Disponível em https://revista.nutricion.org/PDF/NUTRICAO.pdf

Furukawa, A., Furukawa, K., Suzuki, D., Yoshitomi, H., Takayashiki, T., Kuboki, S., ... & Ohtsuka, M. (2021). Efeito da imunonutrição nas complicações infecciosas em pacientes com baixa massa muscular esquelética após duodenopancreatectomia. Clinical Nutrition, 40 (1), 103-109. DOI: https://doi.org/10.1016/j.clnu.2020.04.032

Gianotti L., Braga M., Nespoli., Radaelli G., Beneduce A., Carlo V. (2002). A Randomized Controlled Trial of Preoperative Oral Supplementation With a Specialized Diet in Patients With Gastrointestinal Cancer. American Gasterological Association. DOI: doi:10.1053/gast.2002.33587

Gunerhan, Y., Koksal, N., Sahin, U. Y., Uzun, M. A., & Ekşioglu-Demiralp, E. (2009). Effect of preoperative immunonutrition and other nutrition models on cellular immune parameters. World journal of gastroenterology: WJG, 15(4), 467. DOI: http:// dx.doi.org/10.3748/wjg.15.467

Instituto nacional de câncer José Alencar Gomes da Silva. Tipos de câncer. Rio de Janeiro: INCA, 2020. Disponível em: https://www.inca.gov.br/tipos-de-cancer. Acesso em: 02 de janeiro de 2022.

Lewis, S., Pugsley, M., Schneider, C., Rakita, S. S., & Moudgill, L. J. (2018). The effect of immunonutrition on veterans undergoing major surgery for gastrointestinal cancer. Federal Practitioner, 35(Suppl 4), S49. Visto em https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375420/ as 23h32 do dia 15 de dezembro de 2021.

Luo, Z., Wang, J., Zhang, Z., Li, H., Huang, L., Qiao, Y., ... & Zhang, Y. (2018). Efficacy of early enteral immunonutrition on immune function and clinical outcome for postoperative patients with gastrointestinal cancer. Journal of Parenteral and Enteral Nutrition, 42(4), 758-765. DOI: https://doi.org/10.1177/0148607117715439

Martin II, R. C. G., Agle, S., Schlegel, M., Hayat, T., Scoggins, C. R., McMasters, K. M., & Philips, P. (2017). Efficacy of preoperative immunonutrition in locally advanced pancreatic cancer undergoing irreversible electroporation (IRE). European Journal of Surgical Oncology (EJSO), 43(4), 772-779. DOI: http://dx.doi.org/10.1016/j.ejso.2017.01.002

Nascimento J. E. A., Salomão A. B., Waltzberg D. L., Nascimento D. B. D., Correa M. I. T. D., Campos A. C. L., Corsi P. R., Filho P. E. P. (2017). Caporossi C., Diretriz ACERTO de intervenções nutricionais no perioperatório em cirurgia geral eletiva. Ver. Col. Bras. Cir 2017; 44(6): 633-648. DOI: https://doi.org/10.1590/0100-69912017006003

Peters, M. D, Marnie, C., Tricco, A. C, Pollock, D., Munn, Z., Alexander, L., & Khalil, H. (2020). Orientação metodológica atualizada para a realização de análises de escopo. Síntese de evidências JBI, 18 (10), 2119-2126. 10.11124 / JBIES-20-00167

Schneider S. M., Correia M. I. T. D. (2019). Epidemiology of weight loss, malnutrition and sarcopenia: a transatlantic view. Journal Nutrition (2019), DOI: https://doi.org/10.1016/j.nut.2019.110581

Senkal M., Zumtobel V., Bauer K. H., Marpe B., Wolfram G., Frei A., Eickhoff U., Kemen M. (1999). Outcome and Cost-effectivesess of Perioperative Enteral Immunonutrition in Patients Undergoing Elective Upper Gastrintestinal Tract Surgery. JAMA network ARCH SURG/VOL. 134, 1999. DOI: https://doi:10.1001/archsurg.134.12.1309

Sierra, J. C, Dock-nascimento, D. B, Behne, T. E. G, Rodrigues, H. H. N. P, Andreo, F. O, Palauro, M. L, & De-Aguilar-Nascimento, J. E (2020). Cirurgia oncológica de grande porte reduz a função muscular de pacientes com e sem risco nutricional. Revista do Colégio Brasileiro de Cirurgiões, 47. DOI: https://doi.org/10.1590/0100-6991e-20202470

Silva H. F., Chagas P. S., Negreiros E. N., Souza L. P. (2021). Terapia nutricional imunomoduladora para paciente oncológico no perioperatório gastrintestinal: protocolo de revisão de escopo. Research, Society and Development, v. 10, n. 16. DOI: http://dx.doi.org/10.33448/rsd-v10i16.23599

Sociedade Brasileira de cirurgia oncológica. Rio de Janeiro: SBCO, 2022. Disponível em https://sbco.org.br/. Acesso em 02 de janeiro de 2022.

Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, D., & Straus, S. E. (2018). PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Annals of internal medicine, 169(7), 467-473. DOI: https://doi.org/10.7326/M18-0850

Published

15/05/2022

How to Cite

SILVA, H. F. .; CHAGAS , P. de S. .; NEGREIROS , E. N. .; SOUZA , L. P. de . Effects of Immunomodulatory Nutritional Therapy in cancer patients who have undergone gastrointestinal surgery: a scoping review. Research, Society and Development, [S. l.], v. 11, n. 7, p. e5811729349, 2022. DOI: 10.33448/rsd-v11i7.29349. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/29349. Acesso em: 3 jul. 2022.

Issue

Section

Health Sciences