Parenteral Nutrition Enriched with Fish Oil after Gastrointestinal Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Objective: We performed a systematic review and meta-analysis to assesses the effects of parenteral nutrition enriched with fish oil versus without fish oil after gastrointestinal surgery. Methods: A search was conducted on Medline, Embase and the Cochrane Library electronic databases. Results: After the review of 17 trials, parenteral nutrition enriched with fish oil improved the infection complications rate (risk ratio (RR) = 0.43; 95% CI: 0.28 to 0.67), length of hospital stay (mean difference (MD) = -1.69; 95% CI: -2, 72 to -0.66) and length of intensive care unit stay (MD = -0.33; 95% CI: -0.51 to -0.14). Other beneficial effects included improvement of liver function AST (MD = -18.25; 95% CI,-30.10 to -6.41), immune function CD4+/CD8+ (MD = 0.16; 95% CI: 0.01 to 0.31), reduction of inflammation markers IL-6 (MD = -7.03; 95% CI: -11.10 to -2.97) and TNF-a (MD = -1.18; 95% CI: -1.71 to -0.66), and increased concentrations of EPA (standard mean difference (SMD) = 5.41; 95% CI: 2.47 to 8.34) and DHA (SMD = 3.20; 95% CI: 1.27 to 5.14). Conclusion: Through these results, we conclude that parenteral nutrition enriched with fish oil is safe and effective. However, further studies in larger patient populations with more extensive investigation are needed to reassess the role of FO.