肝癌肝切除术中加强术后恢复方案的安全性和有效性。

IF 2.6 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Clinics and research in hepatology and gastroenterology Pub Date : 2024-11-20 DOI:10.1016/j.clinre.2024.102493

Quan Lv , Ying-Chun Xiang , Yan-Yu Qiu , Zheng Xiang

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引用次数: 0

摘要

目的：本研究旨在评估肝癌肝切除术患者术后增强恢复（ERAS）方案的有效性和安全性：我们检索了从开始到 2023 年 4 月 25 日的三个数据库，包括 PubMed、Embase 和 Cochrane Library 数据库。研究结果为术后并发症和术后住院时间（PLOS）。本研究由Stata（V. 16.0）软件完成：本研究共纳入了 12 项调查，涉及 1,892 名患者。ERAS组的总体术后并发症[几率比（OR）= 0.49，I² = 54.89 %，95 %置信区间（CI）= 0.33-0.74，P = 0.00]、术后Clavien-Dindo 1-2级并发症（OR = 0.39，I² = 55.14 %，95 %CI = 0.23-0.69, P = 0.00）、Clavien-Dindo 3-4 级并发症（OR = 0.56，I² = 0.00 %，95 %CI = 0.38-0.83, P = 0.00）、肺炎（OR = 0.34，I² = 0.00 %，95 %CI = 0.15-0.76, P = 0.01）、腹水（OR = 0.25，I² = 0.00 %，95 %CI = 0.09-0.68, P = 0.01）、呕吐（OR = 0.39, I² = 0.00 %, 95 %CI = 0.21-0.73, P = 0.00）、术中失血[平均差（MD）= 1.69, I² = 0.00 %, 95 %CI = 1.15-2.47, P = 0.01]、PLOS（MD = -0.42, I² = 94.87 %, 95 %CI = -0.86-0.03，P = 0.07）、腹腔引流持续时间（MD = -1.23, I² = 96.96 %, 95 %CI = -2.04 to -0.42，P = 0.00）以及再入院率（OR = 0.44, I² = 0.00 %, 95 %CI = 0.23-0.85, P = 0.01）：结论：对于接受ERAS治疗的肝癌患者，ERAS方案降低了肝癌发生率。结论：对于接受ERAS治疗的肝癌患者，ERAS方案降低了术后并发症的发生率。此外，ERAS 不会增加输血率、再入院率、再次手术率或死亡率。

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Safety and efficacy of the enhanced recovery after surgery protocol in hepatectomy for liver cancer

Purpose

The aim of this research was to evaluate the efficacy and safety of enhanced recovery after surgery (ERAS) protocol in hepatectomy patients with liver cancer.

Materials and methods

We searched three databases, including PubMed, Embase, and the Cochrane Library database, from inception to April 25, 2023. The outcomes were postoperative complications, and postoperative length of stay (PLOS). This study was performed by Stata (V. 16.0) software.

Results

Twelve investigations involving 1,892 patients were included in this study. The ERAS group had lower overall postoperative complications [odds ratio (OR) = 0.49, I² = 54.89 %, 95 % confidence interval (CI) = 0.33–0.74, P = 0.00], postoperative Clavien-Dindo Grade 1–2 complications (OR = 0.39, I² = 55.14 %, 95 %CI = 0.23–0.69, P = 0.00), Clavien-Dindo Grade 3–4 complications (OR = 0.56, I² = 0.00 %, 95 %CI = 0.38–0.83, P = 0.00) , pneumonia (OR = 0.34, I² = 0.00 %, 95 %CI = 0.15–0.76, P = 0.01), ascites (OR = 0.25, I² = 0.00 %, 95 %CI = 0.09–0.68, P = 0.01), vomit (OR = 0.39, I² = 0.00 %, 95 %CI = 0.21–0.73, P = 0.00), intraoperative blood loss [mean difference (MD) = 1.69, I² = 0.00 %, 95 %CI = 1.15–2.47, P = 0.01], PLOS (MD = -0.42, I² = 94.87 %, 95 %CI = -0.86–0.03, P = 0.07), duration of abdominal drain (MD = -1.23, I² = 96.96 %, 95 %CI = -2.04 to -0.42, P = 0.00), and hospital readmission (OR = 0.44, I² = 0.00 %, 95 %CI = 0.23–0.85, P = 0.01) compared to the non-ERAS group.

Conclusion

For patients with liver cancer treated with ERAS. The ERAS protocol reduces the percentage of overall postoperative complications. Moreover, ERAS does not increase the rate of blood transfusions, hospital readmission, reoperation, or mortality.

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来源期刊

Clinics and research in hepatology and gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

4.30

自引率

3.70%

发文量

198

审稿时长

42 days

期刊介绍： Clinics and Research in Hepatology and Gastroenterology publishes high-quality original research papers in the field of hepatology and gastroenterology. The editors put the accent on rapid communication of new research and clinical developments and so called "hot topic" issues. Following a clear Editorial line, besides original articles and case reports, each issue features editorials, commentaries and reviews. The journal encourages research and discussion between all those involved in the specialty on an international level. All articles are peer reviewed by international experts, the articles in press are online and indexed in the international databases (Current Contents, Pubmed, Scopus, Science Direct). Clinics and Research in Hepatology and Gastroenterology is a subscription journal (with optional open access), which allows you to publish your research without any cost to you (unless you proactively chose the open access option). Your article will be available to all researchers around the globe whose institution has a subscription to the journal.