Terapia nutricional perioperatória em pacientes submetidos à hepatectomia devido carcinoma hepatocelular (CHC): revisão sistem[atica de ensaios clínicos randonizados

• Autor(a) principal: Fioretto, Luciana Maria [UNESP]
• Data de Publicação: 2014
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://hdl.handle.net/11449/110348
• topic: Hepatectomia; Figado - Câncer - Cirurgia; Nutrição - Avaliação; Ensaios clínicos; Nutrition Evaluation

Background: Hepatectomy is a surgical procedure indicated for patients with early stage hepatocellular carcinoma, and the results and complications of hepatectomy are related to the preoperative nutritional status of the patient. Thus, numerous perioperative nutritional support proposals to reduce postoperative complications, hospital stays and mortality have emerged. Objective: To evaluate the effectiveness and safety of nutrition therapy during perioperative care in reducing mortality rates for hepatocellular carcinoma patients undergoing hepatectomy compared with standard care. Methods: A systematic review of randomised clinical trials and quasirandomised clinical trials was performed. The following electronic databases were searched: Pubmed, CENTRAL, Embase and Lilacs. The last search date was March 17, 2013. Study selection: In this study were included clinical trials that evaluated perioperative nutritional support in patients with hepatocellular carcinoma undergoing hepatectomy and that presented reduction in mortality rates. Analyses and data collection: Two reviewers independently selected the relevant studies and evaluated the quality of the methodology. Results: The review included two randomised clinical trials in the qualitative synthesis and one in the quantitative synthesis. The following interventions were analysed: operative mortality, postoperative morbidity, the anthropometrics, biochemical and immunological parameters. No statistical operative mortality differences were observed between the perioperative nutritional and control groups (relative risk (RR) 0,52; confiance interval (CI) 95% 0,19-1,47; p=0,22); however, there was a significant between-group difference in postoperative morbidity, there was significant difference between studied groups (RR 0,62; CI 95% 0,45-0,96; p=0,02). The secondary endpoints were not evaluated because we’re not presented on original article, was sent to the author solicitation, ...