Application of enhanced recovery after surgery program in perioperative management of pancreaticoduodenectomy：a systematic review
10.3760/cma.j.issn.1671-0274.2015.02.012
- VernacularTitle:加速康复外科理念在胰十二指肠切除围手术期应用的系统评价
- Author:
Qiucheng LEI
1
;
Xinying WANG
;
Shanjun TAN
;
Xiao WAN
;
Huazhen ZHENG
;
Ning LI
Author Information
1. 210002,南方医科大学南京临床医学院 南京军区南京总医院 解放军普通外科研究所
- Keywords:
Peri-operative management;
Enhanced recovery after surgery;
Pancreaticodu-odenectomy;
Meta-analysis
- From:
Chinese Journal of Gastrointestinal Surgery
2015;(2):143-149
- CountryChina
- Language:Chinese
-
Abstract:
Objective To conduct a systematic review of the safety and efficacy of enhanced recovery after surgery (ERAS) program in perioperative management of pancreaticoduodenectomy. Methods A computerized search was performed in databases including PubMed, Embase, Medline, Web of Science, Cochrane Library, CNKI, Wanfang and VIP for randomized controlled trials (RCTs) or clinical controlled trials (CCTs) describing an ERAS program in patients undergoing pancreaticoduodenectomy published between January 1966 and May 2014. After assessment of methodological quality and data extraction, meta-analysis was performed using RevMan 5.2.0 software. Results Six RCTs and 8 CCTs including 2565 patients were selected for this study , including the study group (n=1366) and the control group (n=1199). Compared with the control group, the study group had a shorter length of hospital stay (WMD=-3.67, 95% CI:-5.66--1.68, P<0.05), lower postoperative complication rate(OR=0.73, 95% CI:0.56-0.95, P<0.05) and lower mortality(OR=0.63, 95% CI:0.44-0.91, P<0.05). However, no significant differences existed in mortality, readmission rate and re-operation rate between the two groups. Conclusions Enhanced recovery after surgery programme in perioperative management of pancreaticoduodenectomy is safe and effective. But due to the medium quality of the literature. This still need more rigorously designed RCTs to prove the safety and efficiency of ERAS programme for the patients undergoing pancreaticoduodenectomy.
