Systematic review of enhanced recovery after surgery in perioperative management of pancreaticoduodenectomy: a meta-analysis of randomized controlled trials and non-randomized controlled trials
10.3760/cma.j.issn.1674-635X.2018.01.001
- VernacularTitle:快速康复外科在胰十二指肠切除术围手术期应用的Meta分析
- Author:
Tao ZHANG
1
;
Liang YU
;
Shunli FAN
;
Fei PAN
;
Dong ZHANG
;
Qiang HE
;
Ren LANG
Author Information
1. 100020,首都医科大学附属北京朝阳医院肝胆胰脾外科
- Keywords:
Enhanced recovery after surgery;
Pancreaticoduodenectomy;
Perioperative;
Meta-analysis
- From:
Chinese Journal of Clinical Nutrition
2018;26(1):1-8
- CountryChina
- Language:Chinese
-
Abstract:
Objective To systematically review the safety and efficacy of enhanced recovery after surgery (ERAS) in perioperative management of pancreaticoduodenectomy.Methods A search was performed in databases (including PubMed,EMASE,Cochrane library,Sinomed,Wangfang,VIP,and CNKI) for randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) up to September 2016 on use of ERAS in patients undergoing pancreaticoduodenectomy.After quality evaluation and data extraction,meta-analysis was performed using RevMan 5.3.Results Four RCTs and Twelve NRCTs involving a total of 2 828 patients were included.1 401 patients were in the ERAS group,and 1 427 in the control group.Meta-analysis results showed that compared with the control group,the ERAS group had shorter length of hospital stay (SMD =-0.36,95 ％ CI =-0.44--0.28,P＜ 0.05) and lower incidence of delayed gastric emptying (RR =0.61,95％ CI=0.51-0.73,P＜0.05).However,no significant differences were observed in pancreatic fistula rate,bile fistula rate,readmission rate,reoperation rate,and overall mortality morbidity rate between the two groups (all P＞0.05).Conclusion It is reasonably safe and efficacious to adopt ERAS in periopetative management of patients undergoing pancreaticoduodenectomy.
