{"title":"ERAS路径护理对胃肠手术患者术后康复的影响:meta分析。","authors":"Fengying Dong, Yan Li, Wenxia Jin, Zhebing Qiu","doi":"10.1186/s12893-025-02976-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aimed to systematically evaluate the impact of the Enhanced Recovery After Surgery (ERAS) pathway on postoperative outcomes-including hospital length of stay, complication rates, readmission, reoperation, and mortality-in patients undergoing gastrointestinal surgery, to provide evidence-based guidance for clinical practice.</p><p><strong>Methods: </strong>We systematically searched PubMed, Cochrane Library, Embase, Web of Science and Scopus databases for randomized controlled trials (RCTs) and cohort studies on ERAS pathway in postoperative rehabilitation. Thirteen studies comprising a total of 5,603 patients were included. Literature screening and quality assessment followed the standards of Cochrane Collaboration and Newcastle-Ottawa scales. Statistical analysis was performed using R software to calculate the relative risk (RR), mean difference (MD) with 95% confidence interval (CI), and heterogeneity through the I² statistic, with significance set at P < 0.05. This systematic review and meta-analysis has been registered in the PROSPERO database (ID: CRD42024608876).</p><p><strong>Results: </strong>The ERAS pathway significantly shortened the postoperative hospital stay (MD = -3.16, 95% CI [-4.10, -2.21], P < 0.01) and reduced the incidence of postoperative complications (RR = 0.70, 95% CI [0.58, 0.84], P < 0.01). It also significantly reduced the readmission rates (RR = 0.75, 95% CI [0.58, 0.96], P = 0.02). However, there was no statistically significant difference in the impact of ERAS pathway on reoperation rate and mortality (RR = 0.59, 95% CI [0.01, 30.14], P = 0.62).</p><p><strong>Conclusions: </strong>ERAS protocols are associated with improved postoperative recovery in gastrointestinal surgery, including shorter hospital stays and reduced complication and readmission rates. Although no significant effects were found for reoperation or mortality, the overall evidence supports the broader clinical adoption of ERAS, with a need for further high-quality studies to address remaining uncertainties.</p>","PeriodicalId":49229,"journal":{"name":"BMC Surgery","volume":"25 1","pages":"239"},"PeriodicalIF":1.8000,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128559/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of ERAS pathway nursing on postoperative rehabilitation of patients undergoing gastrointestinal surgery: a meta-analysis.\",\"authors\":\"Fengying Dong, Yan Li, Wenxia Jin, Zhebing Qiu\",\"doi\":\"10.1186/s12893-025-02976-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aimed to systematically evaluate the impact of the Enhanced Recovery After Surgery (ERAS) pathway on postoperative outcomes-including hospital length of stay, complication rates, readmission, reoperation, and mortality-in patients undergoing gastrointestinal surgery, to provide evidence-based guidance for clinical practice.</p><p><strong>Methods: </strong>We systematically searched PubMed, Cochrane Library, Embase, Web of Science and Scopus databases for randomized controlled trials (RCTs) and cohort studies on ERAS pathway in postoperative rehabilitation. Thirteen studies comprising a total of 5,603 patients were included. Literature screening and quality assessment followed the standards of Cochrane Collaboration and Newcastle-Ottawa scales. Statistical analysis was performed using R software to calculate the relative risk (RR), mean difference (MD) with 95% confidence interval (CI), and heterogeneity through the I² statistic, with significance set at P < 0.05. This systematic review and meta-analysis has been registered in the PROSPERO database (ID: CRD42024608876).</p><p><strong>Results: </strong>The ERAS pathway significantly shortened the postoperative hospital stay (MD = -3.16, 95% CI [-4.10, -2.21], P < 0.01) and reduced the incidence of postoperative complications (RR = 0.70, 95% CI [0.58, 0.84], P < 0.01). It also significantly reduced the readmission rates (RR = 0.75, 95% CI [0.58, 0.96], P = 0.02). However, there was no statistically significant difference in the impact of ERAS pathway on reoperation rate and mortality (RR = 0.59, 95% CI [0.01, 30.14], P = 0.62).</p><p><strong>Conclusions: </strong>ERAS protocols are associated with improved postoperative recovery in gastrointestinal surgery, including shorter hospital stays and reduced complication and readmission rates. Although no significant effects were found for reoperation or mortality, the overall evidence supports the broader clinical adoption of ERAS, with a need for further high-quality studies to address remaining uncertainties.</p>\",\"PeriodicalId\":49229,\"journal\":{\"name\":\"BMC Surgery\",\"volume\":\"25 1\",\"pages\":\"239\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-06-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12128559/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMC Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12893-025-02976-9\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12893-025-02976-9","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景:本研究旨在系统评估ERAS途径对胃肠手术患者术后预后(包括住院时间、并发症发生率、再入院、再手术和死亡率)的影响,为临床实践提供循证指导。方法:系统检索PubMed、Cochrane Library、Embase、Web of Science和Scopus数据库,检索ERAS通路在术后康复中的随机对照试验(RCTs)和队列研究。13项研究共纳入5603例患者。文献筛选和质量评价采用Cochrane协作量表和Newcastle-Ottawa量表。采用R软件进行统计学分析,计算相对危险度(RR)、平均差值(MD)(95%置信区间CI),并通过I²统计进行异质性分析,显著性设置为P。结果:ERAS通路显著缩短了术后住院时间(MD = -3.16, 95% CI [-4.10, -2.21], PERAS方案与改善胃肠道手术术后恢复有关,包括缩短住院时间、减少并发症和再入院率。虽然没有发现对再手术或死亡率的显著影响,但总体证据支持ERAS在临床中的广泛应用,需要进一步的高质量研究来解决剩余的不确定性。
Effect of ERAS pathway nursing on postoperative rehabilitation of patients undergoing gastrointestinal surgery: a meta-analysis.
Background: This study aimed to systematically evaluate the impact of the Enhanced Recovery After Surgery (ERAS) pathway on postoperative outcomes-including hospital length of stay, complication rates, readmission, reoperation, and mortality-in patients undergoing gastrointestinal surgery, to provide evidence-based guidance for clinical practice.
Methods: We systematically searched PubMed, Cochrane Library, Embase, Web of Science and Scopus databases for randomized controlled trials (RCTs) and cohort studies on ERAS pathway in postoperative rehabilitation. Thirteen studies comprising a total of 5,603 patients were included. Literature screening and quality assessment followed the standards of Cochrane Collaboration and Newcastle-Ottawa scales. Statistical analysis was performed using R software to calculate the relative risk (RR), mean difference (MD) with 95% confidence interval (CI), and heterogeneity through the I² statistic, with significance set at P < 0.05. This systematic review and meta-analysis has been registered in the PROSPERO database (ID: CRD42024608876).
Results: The ERAS pathway significantly shortened the postoperative hospital stay (MD = -3.16, 95% CI [-4.10, -2.21], P < 0.01) and reduced the incidence of postoperative complications (RR = 0.70, 95% CI [0.58, 0.84], P < 0.01). It also significantly reduced the readmission rates (RR = 0.75, 95% CI [0.58, 0.96], P = 0.02). However, there was no statistically significant difference in the impact of ERAS pathway on reoperation rate and mortality (RR = 0.59, 95% CI [0.01, 30.14], P = 0.62).
Conclusions: ERAS protocols are associated with improved postoperative recovery in gastrointestinal surgery, including shorter hospital stays and reduced complication and readmission rates. Although no significant effects were found for reoperation or mortality, the overall evidence supports the broader clinical adoption of ERAS, with a need for further high-quality studies to address remaining uncertainties.