There were several limitations in our study. Although quality-assessment results indicated the overall study quality was good, several trials had some risk of bias in their study design, as mentioned earlier. Publication bias always exists and is unavoidable in meta-analyses, and inverted funnel plots of our study indicated potential risks in outcomes of total complication and hospital stay. For infectious outcomes, different doses and kinds of antibiotic used before and after surgery may have caused heterogeneity across the trials. Although the preoperative prophylactic antibiotic was comparable in each separate trial, the intra- and postoperative antibiotic can only be used based on a certain situation of operation time and blood loss, while only half of the trials reported relevant data. SSI was also an important issue in the clinic, and CRC surgery as a clean-contaminated operation had a high risk of SSI,31 although the omega-3 group had a lower SSI incidence and no statistical difference was found. As Braga et al reported, about 25% of postoperative infection, especially wound infection, occurred after discharge,11 and longer follow-up to 1 month would be important for future study.
Short-term omega-3 PUFAs were 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 longer follow-up study.
The authors report no conflicts of interest in this work.
Hai Xie,1 Yan-na Chang2
1Department of Emergency, The First Hospital of Lanzhou University, 2Department of Anesthesiology, Affiliated Hospital of Gansu University of Chinese Medicine, Lanzhou, People’s Republic of China
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Source: OncoTargets and Therapy.
Originally published December 9, 2016.