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. 2016 Dec 9:9:7435-7443.
doi: 10.2147/OTT.S113575. eCollection 2016.

Omega-3 polyunsaturated fatty acids in the prevention of postoperative complications in colorectal cancer: a meta-analysis

Hai Xie  1 , Yan-Na Chang  2
Affiliations

Omega-3 polyunsaturated fatty acids in the prevention of postoperative complications in colorectal cancer: a meta-analysis

Hai Xie et al. Onco Targets Ther. .

Abstract

Objective: To evaluate systematically the clinical efficacy of omega-3 polyunsaturated fatty acids (PUFAs) in the prevention of postoperative complications in colorectal cancer (CRC) patients.

Materials and methods: Published articles were identified by using search terms in online databases - PubMed, Embase, and the Cochrane Library - up to March 2016. Only randomized controlled trials investigating the efficacy of omega-3 PUFAs in CRC were selected and analyzed through a meta-analysis. Subgroup, sensitivity, and inverted funnel-plot analyses were also conducted.

Results: Eleven articles with 694 CRC patients were finally included. Compared with control, omega-3 PUFA-enriched enteral or parenteral nutrition during the perioperative period reduced infectious complications (risk ratio [RR] 0.63, 95% confidence interval [CI] 0.47-0.86; P=0.004), tumor necrosis factor alpha (standard mean difference [SMD] -0.37, 95% CI -0.66 to -0.07; P=0.01), interleukin-6 (SMD -0.36, 95% CI -0.66 to -0.07; P=0.02), and hospital stay (MD -2.09, 95% CI -3.71 to -0.48; P=0.01). No significant difference was found in total complications, surgical site infection, or CD4+:CD8+ cell ratio.

Conclusion: Short-term omega-3 PUFA administration was associated with reduced postoperative infectious complications, inflammatory cytokines, and hospital stay after CRC surgery. Due to heterogeneity and relatively small sample size, the optimal timing and route of administration deserve further study.

Keywords: colorectal surgery; fatty acids; fish oil; meta-analysis; omega-3.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart of trial selection.
Figure 2
Figure 2
Summary of risk of bias.
Figure 3
Figure 3
Meta-analysis results of infectious complications among the groups. Abbreviations: M–H, Mantel–Haenszel; CI, confidence interval.
Figure 4
Figure 4
Meta-analysis results of surgical site infections among the groups. Abbreviations: M–H, Mantel–Haenszel; CI, confidence interval.
Figure 5
Figure 5
Meta-analysis results of total complications among the groups. Abbreviations: M–H, Mantel–Haenszel; CI, confidence interval.
Figure 6
Figure 6
Meta-analysis results of cytokines and CD4+:CD8+ cell ratio among the groups. Abbreviations: SD, standard deviation; IV, instrumental variable; CI, confidence interval; TNFα, tumor necrosis factor; IL-6, interleukin-6.
Figure 7
Figure 7
Meta-analysis of hospital stay among the groups. Abbreviations: SD, standard deviation; IV, instrumental variable; CI, confidence interval.
See this image and copyright information in PMC

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