Vitamin E administration as preventive measures for peritoneal/intra-abdominal adhesions: A systematic review and meta-analysis

Background: Peritoneal adhesion still becoming a common complication after abdominal surgeries and become a significant threat to digestive surgeons nowadays. Vitamin E might offer benefits for preventing peritoneal adhesions because of its antioxidant, anti-inflammatory, and anti-fibroblastic properties. This study sought to analyze the relationship between vitamin E administration and peritoneal/intra-abdominal adhesions in rat models.

Methods: Potential articles were searched by using specific keywords on Scopus, PubMed, PMC, and Cochrane Library databases until March 12th, 2022. All published studies on vitamin E and peritoneal/abdominal adhesions in rat models were collected. Statistical analysis was performed by using Review Manager 5.4 software.

Results: A total of 9 studies were included in the final analysis. Pooled analysis of the evidences yielded an association between vitamin E and decreased incidence of substantial peritoneal/intra-abdominal adhesions (RR 0.46; 95%CI: 0.33-0.64, p < 0.00001, I ² = 61%, random-effect modeling); and reduction in the mean grade of adhesions (Mean Difference -1.53; 95%CI: -2.00, -1.06, p < 0.00001, I ² = 98%, random-effect modeling).

Conclusions: This study proposes that vitamin E supplementation might offer benefits in the prevention of peritoneal/intra-abdominal adhesions. More in-vivo studies with larger sample sizes and proper methods are still needed to confirm the results of our study. If possible, studies on humans might also be warranted.