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Videosurgery and Other Miniinvasive Techniques
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4/2023
vol. 18
 
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General surgery
abstract:
Meta-analysis

An evaluation of the effectiveness and safety of the Enhanced Recovery After Surgery (ERAS) program for patients undergoing colorectal surgery: a meta-analysis of randomized controlled trials

Wenxian Zhang
1
,
Fang Wang
1
,
Shujung Qi
1
,
Zhijun Liu
1
,
Subin Zhao
1
,
Ning Zhang
1
,
Fumin Ping
1

  1. Department of General Surgery, Affiliated Hospital of Hebei Engineering University, Handan, Hebei Province, China
Videosurgery Miniinv 2023; 18 (4): 565–577
DOI: https://doi.org/10.5114/wiitm.2023.131426
Online publish date: 2023/09/20
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Introduction
The Enhanced Recovery After Surgery (ERAS) protocol reduces surgery-related stress and hospital stays for complicated surgical patients. It speeds recovery, reduces readmissions, and lowers morbidity and mortality. However, the efficacy of ERAS in colorectal surgery is still debatable.

Aim
To evaluate the effectiveness and safety of the ERAS program for patients undergoing colorectal surgery.

Material and methods
PRISMA-compliant searches were performed on Medline, Embase, PubMed, the Web of Sciences, and the Cochrane Database up to March 2023. The included articles compared ERAS protocol results for colorectal surgery patients to those of conventional care. RevMan was used for the meta-analysis, and the Cochrane RoB Tool was used to assess the study quality.

Results
The meta-analysis included 12 randomized controlled trials with a total of 1920 participants. There were 880 individuals in ERAS care and 1002 in conventional care. Weighted mean difference: –1.07 days, 95% confidence interval (CI): –1.53 to –0.60, p = 0.00001), overall length of stay: –4.12 days, 95% CI: –5.86 to –2.38, p = 0.00001), and post-operative hospital stay: –1.91 days, 95% CI: –4.73 to –0.91, p = 0.00001). Readmissions were higher in the ERAS group than in the normal care group (odds ratio (OR) = 1.20, 95% CI: 0.82 to 1.75, p = 0.35). Post-operative complications were lower in the ERAS care group (OR = 0.42; 95% CI: 0.27 to 0.65, p < 0.0001) and SSIs (OR = 0.75; 95% CI 0.52 to 1.08, p = 0.00001) than in the routine care group.

Conclusions
Care provided in line with the ERAS protocol has been shown to be successful and beneficial for patients following colorectal surgery, because it minimizes post-operative problems and length of hospital stay, and improves outcomes.

keywords:

postoperative complications, length of hospital stay, meta-analysis, colorectal surgery, Enhanced Recovery after Surgery, fast track surgery
  
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