Brief Reports
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2005; 11(25): 3925-3930
Published online Jul 7, 2005. doi: 10.3748/wjg.v11.i25.3925
Clinical evidence of growth hormone for patients undergoing abdominal surgery: Meta-analysis of randomized controlled trials
Yong Zhou, Xiao-Ting Wu, Gang Yang, Wen Zhuang, Mao-Ling Wei
Yong Zhou, Xiao-Ting Wu, Gang Yang, Wen Zhuang, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Mao-Ling Wei, Chinese Evidence-Based Medicine/Cochrane Center, Chengdu 610041, Sichuan Province, China
Author contributions: All authors contributed equally to the work.
Supported by the China Medical Board of New York No. 98-680
Correspondence to: Professor Xiao-Ting Wu, Department of General Surgery, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu 610041, Sichuan Province, China.
Telephone: +86-28-85422480 Fax: +86-28-85422411
Received: May 27, 2004
Revised: June 12, 2004
Accepted: June 17, 2004
Published online: July 7, 2005

AIM: To assess the effectiveness and safety of perioperative growth hormone (GH) in patients undergoing abdominal surgery.

METHODS: We searched the following electronic databases: MEDLINE, EMBASE, the Cochrane Controlled Trials Register, Chinese Bio-medicine Database. The search was undertaken in February 2003. No language restrictions were applied. Randomized controlled trials (RCT) comparing GH with placebo in patients undergoing abdominal surgery were extracted and evaluated. Methodological quality was evaluated using the Jadad scale.

RESULTS: Eighteen trials involving 646 patients were included. The combined results showed that GH had a positive effect on improving postoperative nitrogen balance (standardized mean difference [SMD] = 3.37, 95%CI [2.46, 4.27], P < 0.00001), and decreasing the length of hospital stay (weighted mean difference [WMD] = -2.07, 95%CI [-3.03, -1.11], P = 0.00002), and reducing the duration of postoperative fatigue syndrome (SMD = -1.83, 95%CI [-2.37, -1.30], P < 0.00001), but it could increase blood glucose levels (WMD = 0.91, 95%CI [0.56, 1.25], P < 0.00001).

CONCLUSION: GH for patients undergoing abdominal surgery is effective and safe, if blood glucose can be controlled well. Further trials are required with a sufficient size to account for clinical heterogeneity and to measure other important outcomes such as infection, morbidity, mortality, fluid retention, immunomodulatory effects, and tumor recurrence.

Keywords: Perioperative growth hormone, Abdominal surgery