Effect of perioperative glutamine-enriched nutritional support on patients with colorectal cancer: A systematic review and meta-analysis

doi:10.4240/wjgs.v17.i12.112256

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Meta-Analysis

World J Gastrointest Surg. Dec 27, 2025; 17(12): 112256
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.112256

Table 4 Subgroup analysis

Outcomes	Category	Study characteristic (number of studies)	Overall MD/SMD (95%CI)	P value
ALB	Type of tumor	CC (5)	4.69 (3.51, 5.87)	^aP < 0.00001
		RC (3)	2.61 (1.40, 3.83)	^aP < 0.00001
		CRC (13)	1.94 (0.77, 3.11)	^aP = 0.001
	Routes	EN (9)	3.02 (2.06, 3.98)	^aP < 0.00001
	Routes	PN (12)	2.32 (1.06, 3.58)	^aP = 0.0003
	Timing of infusion	POD (15)	1.91 (1.02, 2.81)	^aP < 0.0001
	Timing of infusion	Pre-op, POD (6)	4.46 (3.09, 5.82)	^aP < 0.00001
	Sample size	> 30 (8)	4.29 (3.48, 5.09)	^aP < 0.00001
	Sample size	≤ 30 (13)	1.71 (0.77, 2.65)	^aP = 0.0004
PA	Type of tumor	RC (3)	29.67 (14.44, 44.90)	^aP = 0.0001
		CC (5)	16.49 (1.91, 31.08)	^aP = 0.03
		CRC (2)	35.53 (-10.36, 81.41)	P = 0.13
	Routes	EN (5)	39.97 (21.45, 58.50)	^aP < 0.0001
	Routes	PN (5)	13.81 (7.74, 19.88)	^aP < 0.00001
	Timing of infusion	POD (5)	32.22 (14.63, 49.80)	^aP = 0.0003
	Timing of infusion	Pre-op, POD (5)	19.47 (8.97, 29.97)	^aP = 0.0003
	Sample size	> 30 (6)	35.53 (20.40, 50.66)	^aP < 0.00001
	Sample size	≤ 30 (4)	12.15 (7.38, 16.92)	^aP < 0.00001
CD8⁺	Type of tumor	CC (3)	-4.77 (-10.76, 1.22)	P = 0.12
		RC (1)	-2.40 (-3.16, -1.64)	^aP < 0.00001
		CRC (7)	-0.01 (-2.83, 2.82)	P = 1.00
	Routes	EN (5)	-2.07 (-4.40, 0.25)	P = 0.08
	Routes	PN (6)	-1.54 (-6.38, 3.31)	P = 0.53
	Time of duration	> 7 days (5)	-1.16 (-4.82, 2.50)	P = 0.53
	Time of duration	≤ 7 days (6)	-2.13 (-5.13, 0.87)	P = 0.16
	Timing of infusion	POD (7)	-0.49 (-3.15, 2.18)	P = 0.72
	Timing of infusion	Pre-op, POD (4)	-3.74 (-8.82, 1.34)	P = 0.15
	Sample size	> 30 (4)	-2.06 (-5.36, 1.24)	P = 0.22
	Sample size	≤ 30 (7)	-1.64 (-5.20, 1.91)	P = 0.37
CD4⁺/CD8⁺	Type of tumor	CC (2)	0.26 (-0.11, 0.63)	P = 0.17
	Type of tumor	CRC (4)	0.04 (-0.54, 0.61)	P = 0.90
	Routes	EN (3)	-0.06 (-0.67, 0.55)	P = 0.86
	Routes	PN (3)	0.30 (0.02, 0.58)	P = 0.04
	Time of duration	> 7 days (4)	0.03 (-0.46, 0.53)	P = 0.90
	Time of duration	≤ 7 days (2)	0.26 (-0.14, 0.65)	P = 0.20
	Timing of infusion	POD (3)	-0.12 (-0.74, 0.50)	P = 0.70
	Timing of infusion	Pre-op, POD (3)	0.34 (0.07, 0.60)	^aP = 0.01
	Sample size	> 30 (3)	0.21 (-0.04, 0.46)	P = 0.10
	Sample size	≤ 30 (3)	0.03 (-0.86, 0.92)	P = 0.94
IgM	Type of tumor	RC (2)	0.20 (0.14, 0.25)	^aP < 0.00001
	Type of tumor	CRC (5)	0.45 (0.03, 0.88)	^aP = 0.03
	Routes	EN (3)	0.65 (-0.05, 1.36)	P = 0.07
	Routes	PN (4)	0.19 (0.10, 0.29)	^aP < 0.0001
	Time of duration	> 5 days (5)	0.44 (0.03, 0.85)	^aP = 0.04
	Time of duration	≤ 5 days (2)	0.20 (0.15, 0.26)	^aP < 0.00001
	Sample size	> 30 (2)	0.20 (0.14, 0.26)	^aP < 0.00001
	Sample size	≤ 30 (5)	0.45 (0.10, 0.80)	^aP = 0.01
IgG	Type of tumor	RC (2)	2.09 (1.52, 2.66)	^aP < 0.00001
	Type of tumor	CRC (4)	1.04 (-0.23, 2.32)	P = 0.11
	Routes	EN (2)	1.04 (-0.81, 2.88)	P = 0.27
	Routes	PN (4)	1.71 (0.39, 3.03)	^aP = 0.01
	Sample size	> 30 (2)	1.16 (-0.69, 3.01)	P = 0.22
	Sample size	≤ 30 (4)	1.63 (0.10, 3.16)	^aP = 0.04
TNF-α	Type of tumor	CC (3)	-17.77 (-33.20, -2.34)	^aP = 0.02
	Type of tumor	CRC (3)	-8.80 (-21.26, 3.66)	P = 0.17
	Routes	EN (3)	-16.85 (-29.89, -3.81)	^aP = 0.01
	Routes	PN (3)	-9.52 (-21.34, 2.30)	P = 0.11
	Time of duration	≥ 7 days (3)	-16.85 (-29.89, -3.81)	^aP = 0.01
	Time of duration	< 7 days (3)	-9.52 (-21.34, 2.30)	P = 0.11
	Timing of infusion	POD (1)	-4.65 (-5.82, -3.48)	^aP < 0.00001
	Timing of infusion	Pre-op, POD (4)	-14.92 (-24.30, -5.55)	^aP = 0.002
	Sample size	> 30 (3)	-16.85 (-29.89, -3.81)	^aP = 0.01
	Sample size	≤ 30 (3)	-9.52 (-21.34, 2.30)	P = 0.11
CRP	Time of duration	≥ 7 days (2)	-3.83 (-4.35, -3.30)	^aP < 0.00001
CRP	Time of duration	< 7 days (2)	-5.73 (-15.78, 4.31)	P = 0.26
LOS	Type of tumor	CC (2)	-3.16 (-4.13, -2.18)	^aP < 0.00001
	Type of tumor	CRC (8)	-2.07 (-3.20, -0.93)	^aP = 0.0003
	Routes	EN (5)	-1.97 (-3.15, -0.79)	^aP = 0.001
	Routes	PN (5)	-2.64 (-4.25, -1.03)	^aP = 0.001
	Sample size	> 30 (4)	-2.23 (-3.29, -1.16)	^aP < 0.0001
	Sample size	≤ 30 (6)	-2.34 (-4.08, -0.59)	^aP = 0.009

^aP < 0.05.

LOS: Length of hospital stay; ALB: Albumin; PA: Prealbumin; CRC: Colorectal cancer; PN: Parenteral nutrition; EN: Enteral nutrition; TNF-α: Tumor necrosis factor-α; CRP: C-reactive protein; MD: Mean differences; SMD: Standardized mean differences.

Full Size Table

Citation: Huang Y, Yang XZ, Qin SH, Zhang T, Xie M, Wang JW. Effect of perioperative glutamine-enriched nutritional support on patients with colorectal cancer: A systematic review and meta-analysis. World J Gastrointest Surg 2025; 17(12): 112256
URL: https://www.wjgnet.com/1948-9366/full/v17/i12/112256.htm
DOI: https://dx.doi.org/10.4240/wjgs.v17.i12.112256

Huang Y, Yang XZ, Qin SH, Zhang T, Xie M, Wang JW. Effect of perioperative glutamine-enriched nutritional support on patients with colorectal cancer: A systematic review and meta-analysis. World J Gastrointest Surg 2025; 17(12): 112256 [PMID: 41479717 DOI: 10.4240/wjgs.v17.i12.112256]

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