The effectiveness of perioperative oral care in reducing postoperative complications in major cancer surgery: a systematic review and meta-analysis
Lara A.E. De Ruiter, Sanne F. Van de Vrede, Jan Mulder, Johannes H.W. De Wilt, Adelina S. PlachokovaBackground:
Perioperative oral care has been proposed as an effective intervention to reduce postoperative complications in patients undergoing major cancer surgery, however, its effectiveness across different cancer types and surgical procedures remains unclear.
Objective:
To evaluate the effectiveness of perioperative oral care in reducing postoperative complications among patients undergoing major cancer surgery.
Materials and methods:
A systematic literature search was conducted across five databases to identify studies evaluating the effect of perioperative oral care on postoperative outcomes following oncological surgery. Twenty-six studies were included, comprising retrospective and prospective cohort and case–control studies. The primary outcomes were postoperative pneumonia, surgical-site infection (SSI), and mortality. Meta-analyses were performed for postoperative pneumonia and SSI, whereas mortality was analyzed descriptively because of clinical and methodological heterogeneity.
Results:
Perioperative oral care was significantly associated with reduced odds of postoperative pneumonia (OR = 0.47; 95% CI: 0.40–0.54;
Conclusion:
The current evidence suggests that perioperative oral care is associated with lower rates of postoperative pneumonia and SSI in patients undergoing major cancer surgery. However, because the available evidence is derived predominantly from observational studies conducted in Japan, well-designed multicenter randomized controlled trials in different countries and healthcare systems are needed to confirm these findings, improve generalizability, and establish standardized perioperative oral care protocols.