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

Forshaw, Elizabeth, Hajibandeh, Shahin and Hajibandeh, Shahab 2023. Effect of ghrelin administration on postoperative inflammatory response and bodyweight loss in patients with oesophageal cancer undergoing oesophagectomy: a systematic review and meta-analysis. Langenbecks Archive of Surgery 408 , 232. 10.1007/s00423-023-02970-w

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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.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Springer Verlag
Date of First Compliant Deposit:	14 June 2023
Date of Acceptance:	6 June 2023
Last Modified:	10 Feb 2024 02:30
URI:	https://orca.cardiff.ac.uk/id/eprint/160390

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