Enhanced Recovery After Surgery versus Conventional Care in Cholecystectomy: A Systematic Review and Meta-Analysis.

IF 1.1 4区 医学 Q3 SURGERY
Jiao Qin, Ling-Yan Gou, Wei Zhang, Xiao Pu, Ping Zhang
{"title":"Enhanced Recovery After Surgery versus Conventional Care in Cholecystectomy: A Systematic Review and Meta-Analysis.","authors":"Jiao Qin, Ling-Yan Gou, Wei Zhang, Xiao Pu, Ping Zhang","doi":"10.1089/lap.2024.0119","DOIUrl":null,"url":null,"abstract":"<p><p><b><i>Objectives:</i></b> The primary objective of this study was to evaluate the safety and efficacy of the enhanced recovery after surgery (ERAS) protocol in cholecystectomy, comparing it with standard care. <b><i>Methods:</i></b> A comprehensive literature search was conducted in December 2023, using globally recognized databases such as PubMed, Embase, and the Cochrane Library. Various parameters were compared using Review Manager software. This study was duly registered with PROSPERO (CRD420223). <b><i>Results:</i></b> The meta-analysis included nine studies, encompassing a total of 1920 patients. The findings revealed that the ERAS group, in comparison to traditional care, experienced shorter hospitalization periods (weighted mean difference [WMD]: -1.23, 95% confidence interval [CI]: -1.98 to -0.47; <i>P</i> = .001), lower visual analog scale at 24 hours (WMD: -1.10, 95% CI: -1.30 to -0.90; <i>P</i> < .00001), faster time to first flatus (WMD: -4.48, 95% CI: -4.50 to -4.46; <i>P</i> < .00001), and reduced operative times (WMD: -9.94, 95% CI: -17.88 to -0.96; <i>P</i> = .03). In addition, there was a notable decrease in instances of postoperative nausea and vomiting (odds ratio [OR]: 0.46, 95% CI: 0.28 to 0.74; <i>P</i> = .002). No significant differences were observed in readmission rates, blood loss, postoperative complications, or bile leakage between the two care methods. <b><i>Conclusions:</i></b> This study substantiates that the ERAS protocol is an advantageous perioperative care strategy for patients undergoing cholecystectomy. It significantly outperforms traditional care in reducing the length of stay, decreasing the likelihood of postoperative nausea/vomiting, alleviating postoperative pain, and accelerating the time to the first flatus. These findings highlight the effectiveness of ERAS in enhancing patient outcomes in cholecystectomy.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Laparoendoscopic & Advanced Surgical Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1089/lap.2024.0119","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/8 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: The primary objective of this study was to evaluate the safety and efficacy of the enhanced recovery after surgery (ERAS) protocol in cholecystectomy, comparing it with standard care. Methods: A comprehensive literature search was conducted in December 2023, using globally recognized databases such as PubMed, Embase, and the Cochrane Library. Various parameters were compared using Review Manager software. This study was duly registered with PROSPERO (CRD420223). Results: The meta-analysis included nine studies, encompassing a total of 1920 patients. The findings revealed that the ERAS group, in comparison to traditional care, experienced shorter hospitalization periods (weighted mean difference [WMD]: -1.23, 95% confidence interval [CI]: -1.98 to -0.47; P = .001), lower visual analog scale at 24 hours (WMD: -1.10, 95% CI: -1.30 to -0.90; P < .00001), faster time to first flatus (WMD: -4.48, 95% CI: -4.50 to -4.46; P < .00001), and reduced operative times (WMD: -9.94, 95% CI: -17.88 to -0.96; P = .03). In addition, there was a notable decrease in instances of postoperative nausea and vomiting (odds ratio [OR]: 0.46, 95% CI: 0.28 to 0.74; P = .002). No significant differences were observed in readmission rates, blood loss, postoperative complications, or bile leakage between the two care methods. Conclusions: This study substantiates that the ERAS protocol is an advantageous perioperative care strategy for patients undergoing cholecystectomy. It significantly outperforms traditional care in reducing the length of stay, decreasing the likelihood of postoperative nausea/vomiting, alleviating postoperative pain, and accelerating the time to the first flatus. These findings highlight the effectiveness of ERAS in enhancing patient outcomes in cholecystectomy.

胆囊切除术中的术后强化恢复与常规护理:系统综述与元分析》。
研究目的本研究的主要目的是评估在胆囊切除术中加强术后恢复(ERAS)方案的安全性和有效性,并将其与标准护理进行比较。研究方法:于 2023 年 12 月使用全球公认的数据库(如 PubMed、Embase 和 Cochrane Library)进行了全面的文献检索。使用 Review Manager 软件对各种参数进行比较。本研究已在 PROSPERO(CRD420223)正式注册。结果荟萃分析包括九项研究,共涉及 1920 名患者。研究结果显示,与传统护理相比,ERAS 组的住院时间更短(加权平均差 [WMD]:-1.23,95% 置信区间 [CI]:-1.98 至 -0.47;P = .001)、24 小时视觉模拟评分较低(WMD:-1.10,95% CI:-1.30 至 -0.90;P < .00001)、首次排气时间较快(WMD:-4.48,95% CI:-4.50 至 -4.46;P < .00001)、手术时间较短(WMD:-9.94,95% CI:-17.88 至 -0.96;P = .03)。此外,术后恶心和呕吐的情况也明显减少(几率比 [OR]:0.46,95% CI:0.28 至 0.74;P = .002)。两种护理方法在再入院率、失血量、术后并发症或胆汁渗漏方面无明显差异。结论:本研究证实,ERAS 方案对接受胆囊切除术的患者来说是一种有利的围手术期护理策略。它在缩短住院时间、降低术后恶心/呕吐的可能性、减轻术后疼痛和加快首次排气时间方面明显优于传统护理方法。这些研究结果凸显了 ERAS 在提高胆囊切除术患者疗效方面的有效性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信