Enhanced recovery program versus traditional care after hepatectomy: A meta-analysis.

Abstract:

:To assess the safety and efficacy of enhanced recovery after surgery (ERAS) as compared with the traditional care in patients undergoing liver surgery and optimization of enhanced recovery programs.Literature, until August 2016, was searched to identify the comparative studies evaluating preoperative hospital stay time, complications, and C-reactive protein (CRP). Pooled odds ratios (OR) or weighted mean differences (WMDs) were calculated with either the fixed or random effect model.These studies included a total of 524 patients: 254 treated with ERAS and 270 with traditional care. The postoperative recovery time and length of hospital stay were significantly better than the control group (WMD -2.72; 95% confidence interval [CI] -3.86 to -1.57; WMD -2.67; 95% CI -3.68 to -1.65, respectively). The overall complications, grade I, and Grand II-V complications were significantly favorable to the ERAS group (OR, 0.45 [95% CI, 0.30-0.67]; OR, 0.55 [95% CI, 0.31-0.98]; OR, 0.49 [95% CI, 0.32-0.76], respectively). The concentration of CRP in the control group was significantly higher than that in the ERAS group on postoperative day 5 (WMD -21.68; 95% CI -29.30 to -14.05). Time to first flatus (WMD -0.93; 95% CI -1.41 to -0.46) was significantly shortened in the ERAS group.The evidence indicates that ERAS following liver surgery is safe, effective, and feasible. Therefore, further are essential for optimizing the ERAS protocols.

journal_name

Medicine (Baltimore)

journal_title

Medicine

authors

Li L,Chen J,Liu Z,Li Q,Shi Y

doi

10.1097/MD.0000000000008052

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

e8052

issue

38

eissn

0025-7974

issn

1536-5964

pii

00005792-201709220-00025

journal_volume

96

pub_type

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