Systematic Review Of Nutritional Therapy In The Treatment Of Perioperative Ovarian Cancer

Objective:In this study,the safety and efficacy of different nutritional treatments for perioperative ovarian malignancies were evaluated through the traditional meta-analysis and the Bayesian approach based Network meta-analysis.Methods:Through computer retrieval of PubMed,EMBASE,Cochrane library,OVID,CBM,CNKI and Wanfang database,all literatures related to the nutritional treatment of patients with perioperative ovarian malignant tumor were searched.The retrieval period was from database establishment to August 2019,and all references included in the study were traced.Manual retrieval of relevant journals,conference proceedings,dissertation compilation,etc.Revman 5.3,Stata13.0 and GeMTC software were used for statistical analysis.Results:Seven studies were included,with a total of 615 patients and 4 treatment options about ovarian neoplasmas,including oral enteral nutrition therapy,general fluid rehydration therapy,parenteral nutrition therapy,and parenteral-enteral combined nutrition therapy.The results showed that the postoperative hospitalization time of parenteral-enteral nutrition therapy was shorter than that of general fluid therapy(MD =-6.19,95% CI [-9.14 ~-3.24]),and the difference was statistically significant(P < 0.05).Compared to general fluid therapy,both parenteral nutrition therapy and parenteral-enteral nutrition therapy can effectively improve the postoperative serum albumin level(MD = 5.36,95% CI [3.87 ~ 6.85]),postoperative body weight(MD = 2.71,95% CI[1.29 ~ 4.13]),postoperative serum pre-albumin level(MD = 100.77,95% CI [39.38 ~162.17]),and postoperative serum transferrin levels(MD = 0.36,95% CI [0.24 ~ 0.48]),with statistically significant differences(P < 0.05).Probability sequence diagram shows that parenteral-enteral nutrition therapy can obviously reduce postoperative recovery time of intestinal function,,and had a lower incidence of postoperative complications.Nevertheless,parenteral nutrition therapy had more advantages in improving the postoperative serum albumin levels,body weight after operation,postoperative prealbumin and transferrin levels.Conclusion:The existing evidence shows that nutritional therapy for perioperative ovarian malignancy can improve the postoperative nutritional status of patients and shorten the length of hospital stay.Among them,parenteral nutritional therapy has obvious advantages in improving the laboratory indexes of patients’ nutritional status,but the incidence of complications should be paid attention to.Due to the small sample size,the above conclusions still need to be confirmed by high-quality,large-sample randomized controlled studies.