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The effect of the enhanced recovery after surgery program on radical cystectomy: a meta-analysis and systematic review

BACKGROUND: Bladder cancer is the ninth most common malignant tumor worldwide. As an effective evidence-based multidisciplinary protocol, the enhanced recovery after surgery (ERAS) program is practiced in many surgical disciplines. However, the function of ERAS after radical cystectomy remains contr...

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Autores principales: Zhou, Yongheng, Li, Rongyang, Liu, Zhifeng, Qi, Wenqiang, Lv, Guangda, Zhong, Minglei, Liu, Xigao, Zhu, Meikai, Jiang, Zhiwen, Chen, Shouzhen, Shi, Benkang, Zhu, Yaofeng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10235530/
https://www.ncbi.nlm.nih.gov/pubmed/37273829
http://dx.doi.org/10.3389/fsurg.2023.1101098
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author Zhou, Yongheng
Li, Rongyang
Liu, Zhifeng
Qi, Wenqiang
Lv, Guangda
Zhong, Minglei
Liu, Xigao
Zhu, Meikai
Jiang, Zhiwen
Chen, Shouzhen
Shi, Benkang
Zhu, Yaofeng
author_facet Zhou, Yongheng
Li, Rongyang
Liu, Zhifeng
Qi, Wenqiang
Lv, Guangda
Zhong, Minglei
Liu, Xigao
Zhu, Meikai
Jiang, Zhiwen
Chen, Shouzhen
Shi, Benkang
Zhu, Yaofeng
author_sort Zhou, Yongheng
collection PubMed
description BACKGROUND: Bladder cancer is the ninth most common malignant tumor worldwide. As an effective evidence-based multidisciplinary protocol, the enhanced recovery after surgery (ERAS) program is practiced in many surgical disciplines. However, the function of ERAS after radical cystectomy remains controversial. This systematic review and meta-analysis aims to research the impact of ERAS on radical cystectomy. METHODS: A systematic literature search on PubMed, EMBASE, SCOPUS, and the Cochrane Library databases was conducted in April 2022 to identify the studies that performed the ERAS program in radical cystectomy. Studies were selected, data extraction was performed independently by two reviewers, and quality was assessed using a random effects model to calculate the overall effect size. The odds ratio and standardized mean difference (SMD) with a 95% confidence interval (CI) served as the summary statistics for the meta-analysis. A sensitivity analysis was subsequently performed. RESULTS: A total of 25 studies with 4,083 patients were enrolled. The meta-analysis showed that the complications (OR = 0.76; 95% CI: 0.63–0.90), transfusion rate (OR = 0.59; 95% CI: 0.39–0.90), readmission rate (OR = 0.79; 95% CI: 0.64–0.96), length of stay (SMD = −0.79; 95% CI: −1.41 to −0.17), and time to first flatus (SMD = −1.16; 95% CI: −1.58 to −0.74) were significantly reduced in the ERAS group. However, no significance was found in 90-day mortality and urine leakage. CONCLUSION: The ERAS program for radical cystectomy can effectively decrease the risk of overall complications, postoperative ileus, readmission rate, transfusion rate, length of stay, and time to first flatus in patients who underwent radical cystectomy with relative safety. SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/, identifier INPLASY202250075.
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spelling pubmed-102355302023-06-03 The effect of the enhanced recovery after surgery program on radical cystectomy: a meta-analysis and systematic review Zhou, Yongheng Li, Rongyang Liu, Zhifeng Qi, Wenqiang Lv, Guangda Zhong, Minglei Liu, Xigao Zhu, Meikai Jiang, Zhiwen Chen, Shouzhen Shi, Benkang Zhu, Yaofeng Front Surg Surgery BACKGROUND: Bladder cancer is the ninth most common malignant tumor worldwide. As an effective evidence-based multidisciplinary protocol, the enhanced recovery after surgery (ERAS) program is practiced in many surgical disciplines. However, the function of ERAS after radical cystectomy remains controversial. This systematic review and meta-analysis aims to research the impact of ERAS on radical cystectomy. METHODS: A systematic literature search on PubMed, EMBASE, SCOPUS, and the Cochrane Library databases was conducted in April 2022 to identify the studies that performed the ERAS program in radical cystectomy. Studies were selected, data extraction was performed independently by two reviewers, and quality was assessed using a random effects model to calculate the overall effect size. The odds ratio and standardized mean difference (SMD) with a 95% confidence interval (CI) served as the summary statistics for the meta-analysis. A sensitivity analysis was subsequently performed. RESULTS: A total of 25 studies with 4,083 patients were enrolled. The meta-analysis showed that the complications (OR = 0.76; 95% CI: 0.63–0.90), transfusion rate (OR = 0.59; 95% CI: 0.39–0.90), readmission rate (OR = 0.79; 95% CI: 0.64–0.96), length of stay (SMD = −0.79; 95% CI: −1.41 to −0.17), and time to first flatus (SMD = −1.16; 95% CI: −1.58 to −0.74) were significantly reduced in the ERAS group. However, no significance was found in 90-day mortality and urine leakage. CONCLUSION: The ERAS program for radical cystectomy can effectively decrease the risk of overall complications, postoperative ileus, readmission rate, transfusion rate, length of stay, and time to first flatus in patients who underwent radical cystectomy with relative safety. SYSTEMATIC REVIEW REGISTRATION: https://inplasy.com/, identifier INPLASY202250075. Frontiers Media S.A. 2023-05-19 /pmc/articles/PMC10235530/ /pubmed/37273829 http://dx.doi.org/10.3389/fsurg.2023.1101098 Text en © 2023 Zhou, Li, Liu, Qi, Lv, Zhong, Liu, Zhu, Jiang, Chen, Shi and Zhu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Surgery
Zhou, Yongheng
Li, Rongyang
Liu, Zhifeng
Qi, Wenqiang
Lv, Guangda
Zhong, Minglei
Liu, Xigao
Zhu, Meikai
Jiang, Zhiwen
Chen, Shouzhen
Shi, Benkang
Zhu, Yaofeng
The effect of the enhanced recovery after surgery program on radical cystectomy: a meta-analysis and systematic review
title The effect of the enhanced recovery after surgery program on radical cystectomy: a meta-analysis and systematic review
title_full The effect of the enhanced recovery after surgery program on radical cystectomy: a meta-analysis and systematic review
title_fullStr The effect of the enhanced recovery after surgery program on radical cystectomy: a meta-analysis and systematic review
title_full_unstemmed The effect of the enhanced recovery after surgery program on radical cystectomy: a meta-analysis and systematic review
title_short The effect of the enhanced recovery after surgery program on radical cystectomy: a meta-analysis and systematic review
title_sort effect of the enhanced recovery after surgery program on radical cystectomy: a meta-analysis and systematic review
topic Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10235530/
https://www.ncbi.nlm.nih.gov/pubmed/37273829
http://dx.doi.org/10.3389/fsurg.2023.1101098
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