Cargando…
Enhanced recovery after surgery protocol in oesophageal cancer surgery: Systematic review and meta-analysis
BACKGROUND: Enhanced Recovery After Surgery (ERAS) protocol are well established in many surgical disciplines, leading to decrease in morbidity and length of hospital stay. These multi-modal protocols have been also introduced to oesophageal cancer surgery. This review aimed to evaluate current lite...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370110/ https://www.ncbi.nlm.nih.gov/pubmed/28350805 http://dx.doi.org/10.1371/journal.pone.0174382 |
_version_ | 1782518183265042432 |
---|---|
author | Pisarska, Magdalena Małczak, Piotr Major, Piotr Wysocki, Michał Budzyński, Andrzej Pędziwiatr, Michał |
author_facet | Pisarska, Magdalena Małczak, Piotr Major, Piotr Wysocki, Michał Budzyński, Andrzej Pędziwiatr, Michał |
author_sort | Pisarska, Magdalena |
collection | PubMed |
description | BACKGROUND: Enhanced Recovery After Surgery (ERAS) protocol are well established in many surgical disciplines, leading to decrease in morbidity and length of hospital stay. These multi-modal protocols have been also introduced to oesophageal cancer surgery. This review aimed to evaluate current literature on ERAS in oesophageal cancer surgery and conduct a meta-analysis on primary and secondary outcomes. METHODS: MEDLINE, Embase, Scopus and Cochrane Library were searched for eligible studies. We analyzed data up to May 2016. Eligible studies had to contain four described ERAS protocol elements. The primary outcome was overall morbidity. Secondary outcomes included length of hospital stay, specific complications, mortality and readmissions. Random effect meta-analyses were undertaken. RESULTS: Initial search yielded 1,064 articles. Thorough evaluation resulted in 13 eligible articles which were analyzed. A total of 2,042 patients were included in the analysis (1,058 ERAS group and 984 treated with traditional protocols). Analysis of overall morbidity as well as complication rate did not show any significant reduction. Non-surgical complications and pulmonary complications were significantly lower in the ERAS group, RR = 0.71 95% CI 0.62–0.80, p < 0.00001 and RR = 0.75, 95% CI 0.60–0.94, p = 0.01, respectively. Meta-analysis on length of stay presented significant reduction Mean difference = -3.55, 95% CI -4.41 to -2.69, p for effect<0.00001. CONCLUSIONS: This systematic review with a meta-analysis on ERAS in oesophageal surgery indicates a reduction of non-surgical complications and no negative influence on overall morbidity. Moreover, a reduction in the length of hospital stay was presented. |
format | Online Article Text |
id | pubmed-5370110 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-53701102017-04-06 Enhanced recovery after surgery protocol in oesophageal cancer surgery: Systematic review and meta-analysis Pisarska, Magdalena Małczak, Piotr Major, Piotr Wysocki, Michał Budzyński, Andrzej Pędziwiatr, Michał PLoS One Research Article BACKGROUND: Enhanced Recovery After Surgery (ERAS) protocol are well established in many surgical disciplines, leading to decrease in morbidity and length of hospital stay. These multi-modal protocols have been also introduced to oesophageal cancer surgery. This review aimed to evaluate current literature on ERAS in oesophageal cancer surgery and conduct a meta-analysis on primary and secondary outcomes. METHODS: MEDLINE, Embase, Scopus and Cochrane Library were searched for eligible studies. We analyzed data up to May 2016. Eligible studies had to contain four described ERAS protocol elements. The primary outcome was overall morbidity. Secondary outcomes included length of hospital stay, specific complications, mortality and readmissions. Random effect meta-analyses were undertaken. RESULTS: Initial search yielded 1,064 articles. Thorough evaluation resulted in 13 eligible articles which were analyzed. A total of 2,042 patients were included in the analysis (1,058 ERAS group and 984 treated with traditional protocols). Analysis of overall morbidity as well as complication rate did not show any significant reduction. Non-surgical complications and pulmonary complications were significantly lower in the ERAS group, RR = 0.71 95% CI 0.62–0.80, p < 0.00001 and RR = 0.75, 95% CI 0.60–0.94, p = 0.01, respectively. Meta-analysis on length of stay presented significant reduction Mean difference = -3.55, 95% CI -4.41 to -2.69, p for effect<0.00001. CONCLUSIONS: This systematic review with a meta-analysis on ERAS in oesophageal surgery indicates a reduction of non-surgical complications and no negative influence on overall morbidity. Moreover, a reduction in the length of hospital stay was presented. Public Library of Science 2017-03-28 /pmc/articles/PMC5370110/ /pubmed/28350805 http://dx.doi.org/10.1371/journal.pone.0174382 Text en © 2017 Pisarska et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Pisarska, Magdalena Małczak, Piotr Major, Piotr Wysocki, Michał Budzyński, Andrzej Pędziwiatr, Michał Enhanced recovery after surgery protocol in oesophageal cancer surgery: Systematic review and meta-analysis |
title | Enhanced recovery after surgery protocol in oesophageal cancer surgery: Systematic review and meta-analysis |
title_full | Enhanced recovery after surgery protocol in oesophageal cancer surgery: Systematic review and meta-analysis |
title_fullStr | Enhanced recovery after surgery protocol in oesophageal cancer surgery: Systematic review and meta-analysis |
title_full_unstemmed | Enhanced recovery after surgery protocol in oesophageal cancer surgery: Systematic review and meta-analysis |
title_short | Enhanced recovery after surgery protocol in oesophageal cancer surgery: Systematic review and meta-analysis |
title_sort | enhanced recovery after surgery protocol in oesophageal cancer surgery: systematic review and meta-analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5370110/ https://www.ncbi.nlm.nih.gov/pubmed/28350805 http://dx.doi.org/10.1371/journal.pone.0174382 |
work_keys_str_mv | AT pisarskamagdalena enhancedrecoveryaftersurgeryprotocolinoesophagealcancersurgerysystematicreviewandmetaanalysis AT małczakpiotr enhancedrecoveryaftersurgeryprotocolinoesophagealcancersurgerysystematicreviewandmetaanalysis AT majorpiotr enhancedrecoveryaftersurgeryprotocolinoesophagealcancersurgerysystematicreviewandmetaanalysis AT wysockimichał enhancedrecoveryaftersurgeryprotocolinoesophagealcancersurgerysystematicreviewandmetaanalysis AT budzynskiandrzej enhancedrecoveryaftersurgeryprotocolinoesophagealcancersurgerysystematicreviewandmetaanalysis AT pedziwiatrmichał enhancedrecoveryaftersurgeryprotocolinoesophagealcancersurgerysystematicreviewandmetaanalysis |