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Erschienen in:
10.05.2018 | Scientific Review
Enhanced Recovery After Surgery Programs for Laparoscopic Abdominal Surgery: A Systematic Review and Meta-analysis
Erschienen in: World Journal of Surgery | Ausgabe 11/2018
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Background
Enhanced recovery after surgery (ERAS) protocols or laparoscopic technique has been applied in various surgical procedures. However, the clinical efficacy of combination of the two methods still remains unclear. Thus, our aim was to assess the role of ERAS protocols in laparoscopic abdominal surgery.
Methods
We performed a systematic literature search in various databases from January 1990 to October 2017. The results were analyzed according to predefined criteria.
Results
In the present meta-analysis, the outcomes of 34 comparative studies (15 randomized controlled studies and 19 non-randomized controlled studies) enrolling 3615 patients (1749 in the ERAS group and 1866 in the control group) were pooled. ERAS group was associated with shorter hospital stay (WMD − 2.37 days; 95% CI − 3.00 to − 1.73; P 0.000) and earlier time to first flatus (WMD − 0.63 days; 95% CI − 0.90 to − 0.36; P 0.000). Meanwhile, lower overall postoperative complication rate (OR 0.62; 95% CI 0.51–0.76; P 0.000) and less hospital cost (WMD 801.52 US dollar; 95% CI − 918.15 to − 684.89; P 0.000) were observed in ERAS group. Similar readmission rate (OR 0.73, 95% CI 0.52–1.03, P 0.070) and perioperative mortality (OR 1.33; 95% CI 0.53–3.34; P 0.549) were found between the two groups.
Conclusions
ERAS protocol for laparoscopic abdominal surgery is safe and effective. ERAS combined with laparoscopic technique is associated with faster postoperative recovery without increasing readmission rate and perioperative mortality.