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Meta-Analysis
. 2017 Sep;96(38):e8052.
doi: 10.1097/MD.0000000000008052.

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

Le Li  1 , Jinming Chen, Zhonghua Liu, Qiang Li, Ying Shi
Affiliations
Meta-Analysis

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

Le Li et al. Medicine (Baltimore). 2017 Sep.

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.

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Conflict of interest statement

Conflicts of Interest: All authors declare that they have no conflict of interests.

Figures

Figure 1
Figure 1
Identification of studies for inclusion.
Figure 2
Figure 2
Forest plot: the overall complications by ERAS versus conventional care after hepatectomy. ERAS = enhanced recovery after surgery.
Figure 3
Figure 3
Funnel plot: the overall complications by ERAS versus conventional care after hepatectomy. ERAS = enhanced recovery after surgery.
See this image and copyright information in PMC

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