Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2596-2618
Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2596
Effect of perioperative branched chain amino acids supplementation in liver cancer patients undergoing surgical intervention: A systematic review
Kwan Yi Yap, HongHui Chi, Sherryl Ng, Doris HL Ng, Vishal G Shelat
Kwan Yi Yap, HongHui Chi, Sherryl Ng, Vishal G Shelat, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
Doris HL Ng, Department of Gastroenterology and Hepatology, Tan Tock Seng Hospital, Singapore 308433, Singapore
Doris HL Ng, Vishal G Shelat, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 636921, Singapore
Vishal G Shelat, Department of General Surgery, Tan Tock Seng Hospital, Singapore 308433, Singapore
Co-first authors: Kwan Yi Yap and HongHui Chi.
Author contributions: Yap KY acquisition of data, analysis and interpretation of data, drafting the article, revising the article, final approval; Chi H acquisition of data, analysis and interpretation of data, drafting the article, revising the article, final approval; Ng S acquisition of data, interpretation of data, final approval; Ng DH revising the article; Shelat VG supervision, critical revision, final approval. Yap KY and Chi H contributed equally to this work as co-first authors. This research is the product of the collaborative effort of the team, and the designation of co-first authors authorship is reflective of the time and effort invested by the co-first authors into the completion of the research. Furthermore, the decision of co-first authors authorship acknowledges and respects the equal contribution made by both co-first authors throughout the process of writing the paper. As a whole, the team believes that designating Yap KY and Chi H as co-first authors is appropriate and reflective of the team’s collective spirit and wishes.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vishal G Shelat, DNB, FICS, FRCS (Gen Surg), MBBS, MMed, MNAMS, MS, Associate Professor, Director, Surgical Oncologist, Department of General Surgery, Tan Tock Seng Hospital, No. 11 Jalan Tan Tock Seng, Singapore 308433, Singapore. vgshelat@gmail.com
Received: July 31, 2023
Peer-review started: July 31, 2023
First decision: September 5, 2023
Revised: September 15, 2023
Accepted: October 23, 2023
Article in press: October 23, 2023
Published online: November 27, 2023
Processing time: 118 Days and 19.6 Hours
ARTICLE HIGHLIGHTS
Research background

Branched chain amino acids (BCAA) show promising results in improving surgical outcomes in liver cancer patients and potential for routine use.

Research motivation

Current studies on BCAA supplementation show varying results but with no clear conclusion and no updated reviews on the matter.

Research objectives

To provide the most updated review on whether BCAA supplementation provides measurable benefits in liver cancer patients for surgical intervention.

Research methods

Current trials and studies on BCAA supplementation in liver cancer patients undergoing surgery were appraised by three independent authors. Studies were identified and data extracted for meta-analysis of the relevant outcomes.

Research results

Perioperative BCAA supplementation reduced postoperative infections, length of stay and increased body weight in the studied patient groups but did not improve mortality, oncological recurrence, and long-term survival.

Research conclusions

This review has shown that BCAA supplementation improves postoperative outcomes with no significant side effects. However, benefits on oncological outcomes remain inconclusive.

Research perspectives

This review highlights the possible routine use of BCAA for liver cancer patients for surgical intervention. Further clinical research can be directed at assessing optimal BCAA supplementation regime for such patients.