SummaryIntroductionOncologic surgeries are common and rates of depression and anxiety are high in the peri‐operative period, potentially interfering with successful recovery.MethodsWe conducted a narrative review and meta‐analysis focusing on randomised controlled trials evaluating the effect of peri‐operative mental health interventions on anxiety and/or depression in adult patients having oncological surgery. The review included studies published in the last 5 years, identified through EMBASE with no pre‐specified criteria for the type of comparison or outcome. A meta‐analysis using a random effects model was performed for outcomes with sufficient data, and a vote‐counting synthesis was performed for studies with insufficient data or fewer than two studies per outcome.ResultsSeventeen randomised controlled trials were included. All were conducted internationally, primarily in Asia. Ten studies assessed psychological interventions (e.g. cognitive behavioural therapy), six assessed pharmacological interventions (e.g. ketamine) and one assessed acupuncture. Meta‐analysis revealed significant intervention effects on pre‐operative anxiety scores (n = 429, Hedge's g = ‐1.03, p = 0.001) and postoperative depression scores at hospital discharge (n = 188, Hedge's g = ‐0.88, p < 0.001), whereas no significant intervention effect was found in anxiety scores at discharge (n = 188, Hedge's g = ‐1.54, p = 0.08). Vote‐counting synthesis identified intervention effects on depression and anxiety scores on day 3 postoperatively and on depression scores at one‐week postoperatively, while all other time‐points showed no intervention effect.DiscussionPsychological and pharmacological interventions are effective at reducing pre‐operative anxiety and immediate postoperative depression scores in patients having oncological surgery, but these benefits do not persist postoperatively. Hence, future research efforts should focus on development and testing of interventions that are effective and implementable within the peri‐operative context.

中文翻译：

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外科肿瘤患者的围手术期心理健康干预：叙述性综合和荟萃分析


摘要简介肿瘤手术很常见，围手术期抑郁和焦虑的发生率很高，可能会干扰成功康复。方法我们进行了叙述性评价和荟萃分析，重点关注随机对照试验，以评估围手术期心理健康干预对接受肿瘤手术的成年患者焦虑和/或抑郁的影响。本综述纳入了过去 5 年发表的研究，这些研究是通过 EMBASE 确定的，没有预先指定的比较类型或结局标准。对于数据充足的结局，使用随机效应模型进行荟萃分析，对于数据不足或每个结局少于两项研究的研究，进行计票综合。结果共纳入 17 项随机对照试验。所有研究均在国际上进行，主要在亚洲进行。10项研究评估了心理干预（如认知行为疗法），6项研究评估了药物干预（如氯胺酮），1项研究评估了针灸。荟萃分析显示，干预对术前焦虑评分 （n = 429，Hedge 的 g = -1.03，p = 0.001） 和出院时的术后抑郁评分 （n = 188，Hedge 的 g = -0.88，p < 0.001） 有显著的干预作用，而在出院时的焦虑评分中没有发现显着的干预作用 （n = 188，Hedge 的 g = -1.54，p = 0.08）。计票综合确定了对术后第 3 天的抑郁和焦虑评分以及术后 1 周抑郁评分的干预影响，而所有其他时间点均显示无干预效果。讨论心理和药物干预可有效降低肿瘤手术患者的术前焦虑和术后即刻抑郁评分，但这些益处在术后不会持续存在。因此，未来的研究工作应侧重于开发和测试在围手术期环境中有效且可实施的干预措施。