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Meta-Analysis
. 2023 Jun 14;408(1):232.
doi: 10.1007/s00423-023-02970-w.

Effect of ghrelin administration on postoperative inflammatory response and bodyweight loss in patients with oesophageal cancer undergoing oesophagectomy: a systematic review and meta-analysis

Elizabeth Forshaw  1 , Shahin Hajibandeh  2 , Shahab Hajibandeh  3
Affiliations
Meta-Analysis

Effect of ghrelin administration on postoperative inflammatory response and bodyweight loss in patients with oesophageal cancer undergoing oesophagectomy: a systematic review and meta-analysis

Elizabeth Forshaw et al. Langenbecks Arch Surg. .

Abstract

Objectives: To investigate the effect of postoperative ghrelin therapy on postoperative inflammatory response and bodyweight loss in patients undergoing an oesophagectomy for oesophageal cancer.

Methods: We conducted a systematic search using electronic information databases in accordance to PRISMA standards to identify studies comparing outcomes after oesophagectomy in patients who were and were not administered ghrelin in the postoperative period. Meta-analysis of the outcomes using random effects modelling was conducted. The Cochrane collaboration's tool and ROBINS-I tool were used for risk of bias assessment of the included studies.

Results: Five studies including 192 patients were selected for analysis. Ghrelin therapy was associated with a significantly shorter duration of systemic inflammatory response syndrome (SIRS) (MD: - 2.72, P = 0.0001), lower CRP level on postoperative day 3 (MD: - 3.64, P < 0.0001), and less total bodyweight loss (MD: - 1.87, P = 0.14). There was no differences between the two groups in IL-6 level on postoperative day 3 (MD: - 19.65, P = 0.32), total lean body weight loss (MD: - 1.87, P = 0.14), total body fat loss (MD: 0.15, P = 0.84), pulmonary complications (OR: 0.47, P = 0.12), anastomotic leak (OR: 1.17, P = 0.78), wound complications (OR: 1.64, P = 0.63), postoperative bleeding (OR: 0.32, P = 0.33), arrhythmia (OR: 1.22, P = 0.77).

Conclusions: Administration of ghrelin following oesophagoectomy may reduce duration of postoperative SIRS and bodyweight loss. Whether shorter duration of SIRS and less bodyweight loss resulted from postoperative ghrelin therapy can translate into improved morbidity or mortality outcomes remains unknown. There is a need for randomised controlled trials with robust statistical power to investigate the role of postoperative ghrelin therapy on morbidity and mortality outcomes in patients undergoing oesophagectomy.

Keywords: Ghrelin; Oesophageal cancer; Oesophagectomy.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart
Fig. 2
Fig. 2
Forest plot for comparison of frequency of adverse outcomes between the ghrelin therapy and no ghrelin therapy groups
Fig. 2
Fig. 2
Forest plot for comparison of frequency of adverse outcomes between the ghrelin therapy and no ghrelin therapy groups
See this image and copyright information in PMC

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