Cheng Wang1, Guoqun Zheng1, Wenlong Zhang1, Fabiao Zhang1, Shangdong Lv1, Aidong Wang1, Zheping Fang2. 1. Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, China. 2. Department of Hepatobiliary Surgery, Taizhou Hospital of Zhejiang Province, Wenzhou Medical University, 150 Ximen Street, Linhai, 317000, China. fangzheping@yeah.net.
Abstract
BACKGROUND AND AIMS: Due to the limited number of high-quality randomized controlled trials on enhanced recovery after surgery for hepatectomy, previous reviews have not been sufficiently comprehensive. Our objectives were to evaluate and compare the safety and efficacy of enhanced recovery after surgery programs and traditional care in patients undergoing open or laparoscopic surgery and to assess the optimized items for hepatectomy. METHODS: We searched the PubMed, Embase, and the Cochrane Library databases for all the relevant studies regardless of study design. We assessed the methodological quality of the included studies and excluded studies of poor quality. We performed a meta-analysis using RevMan 5.3 software. RESULTS: In total, 19 original studies with 2575 patients, including four randomized controlled trials and 15 non-randomized controlled trials, were analyzed. The meta-analysis demonstrated that enhanced recovery after surgery programs could reduce morbidity, hospital stays and cost, blood loss, and time to bowel function recovery for both open and laparoscopic surgery without increasing mortality, readmission rate, or transfusion rate. Twelve items were essential for liver surgery. CONCLUSIONS: Enhanced recovery after surgery programs for hepatectomy are feasible and efficient. Further studies should optimize perioperative outcomes for liver surgery.
BACKGROUND AND AIMS: Due to the limited number of high-quality randomized controlled trials on enhanced recovery after surgery for hepatectomy, previous reviews have not been sufficiently comprehensive. Our objectives were to evaluate and compare the safety and efficacy of enhanced recovery after surgery programs and traditional care in patients undergoing open or laparoscopic surgery and to assess the optimized items for hepatectomy. METHODS: We searched the PubMed, Embase, and the Cochrane Library databases for all the relevant studies regardless of study design. We assessed the methodological quality of the included studies and excluded studies of poor quality. We performed a meta-analysis using RevMan 5.3 software. RESULTS: In total, 19 original studies with 2575 patients, including four randomized controlled trials and 15 non-randomized controlled trials, were analyzed. The meta-analysis demonstrated that enhanced recovery after surgery programs could reduce morbidity, hospital stays and cost, blood loss, and time to bowel function recovery for both open and laparoscopic surgery without increasing mortality, readmission rate, or transfusion rate. Twelve items were essential for liver surgery. CONCLUSIONS: Enhanced recovery after surgery programs for hepatectomy are feasible and efficient. Further studies should optimize perioperative outcomes for liver surgery.
Authors: Ronald M van Dam; Edgar M Wong-Lun-Hing; Gerard J P van Breukelen; Jan H M B Stoot; Joost R van der Vorst; Marc H A Bemelmans; Steven W M Olde Damink; Kristoffer Lassen; Cornelis H C Dejong Journal: Trials Date: 2012-05-06 Impact factor: 2.279
Authors: Nicolai A Schultz; Peter N Larsen; B Klarskov; L M Plum; Hans-Jørgen Frederiksen; Henrik Kehlet; Jens G Hillingsø Journal: World J Surg Date: 2018-06 Impact factor: 3.352
Authors: Steven D Scoville; Dimitrios Xourafas; Aslam M Ejaz; Allan Tsung; Timothy Pawlik; Jordan M Cloyd Journal: World J Gastrointest Surg Date: 2020-04-27
Authors: Andreas Andreou; Sebastian Knitter; Sascha Chopra; Christian Denecke; Moritz Schmelzle; Benjamin Struecker; Ann-Christin Heilmann; Johanna Spenke; Tobias Hofmann; Peter C Thuss-Patience; Marcus Bahra; Johann Pratschke; Matthias Biebl Journal: J Gastrointest Surg Date: 2018-10-03 Impact factor: 3.452
Authors: David P J van Dijk; Victor van Woerden; Hamit Cakir; Marcel den Dulk; Steven W M Olde Damink; Cornelis H C Dejong Journal: J Surg Oncol Date: 2017-08-02 Impact factor: 3.454