Application of enhanced recovery after surgery in perioperative period of hepatectomy:a Meta - analysis / 临床肝胆病杂志

ABSTRACT

Objective To systematically review the value of enhanced recovery after surgery(ERAS)in the perioperative period of hepatec-tomy. Methods A literature search was conducted in PubMed,Embase,Cochrane Library,Sinomed,Wanfang Data,VIP,and CNKI to iden-tify the articles on the application of ERAS in the perioperative period of hepatectomy published up to July 2017. Quality evaluation and data extraction were performed for the included articles. A Meta - analysis was performed using Revman 5.3 software. Results A total of 17 articles were included,with 14 randomized controlled trials and 3 controlled clinical trials. A total of 2220 patients were involved and divided into ERAS group(n=1002)and control group(n=1218). Compared with the control group,the ERAS group had significantly shortened length of postoperative hospital stay(weighted mean difference[WMD]= -2.58,95% confidence interval[CI]-3.47 to-1.70,P<0.05),functional rehabilitation time(WMD= -3.39,95%CI-4.32 to -2.45,P<0.05),and time to first flatus(standardized mean difference[SMD]= -1.56,95%CI-2.15 to -0.97,P<0.05),as well as reduced complication rate(odds ratio[OR]=0.64,95%CI0.52-0.78,P<0.05)and hospital costs(SMD= -0.85,95%CI-1.23 to -0.47,P<0.05).There were no significant differences between the two groups in readmission rate(OR =1.28,95%CI0.69 -2.69,P > 0.05),operation time(WMD = -11.36,95%CI-23.25 to 0.53,P>0.05),and intraoperative blood loss(WMD= -22.62,95%CI-38.89 to -6.34,P>0.05).Conclusion ERAS is safe and effective in the perioperative period of hepatectomy and holds promise for clinical application.