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The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials
Division of Gastrointestinal Surgery, Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, Nottingham University Hospitals, Queen’s Medical Centre, Nottingham, UK.
Department of Epidemiology and Public Health, Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, Nottingham University Hospitals, Queen’s Medical Centre, Nottingham, UK.
Department of Surgery, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands.
Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK.
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2010 (English)In: Clinical Nutrition, ISSN 0261-5614, E-ISSN 1532-1983, Vol. 29, no 4, p. 434-40Article in journal (Refereed) Published
Abstract [en]

Background & aims: The aim of the Enhanced Recovery After Surgery (ERAS) pathway is to attenuate the stress response to surgery and enable rapid recovery. The objective of this meta-analysis was to study the differences in outcomes in patients undergoing major elective open colorectal surgery within an ERAS pathway and those treated with conventional perioperative care.

Methods: Medline, Embase and Cochrane database searches were performed for relevant studies published between January 1966 and November 2009. All randomized controlled trials comparing ERAS with conventional perioperative care were selected. The outcome measures studied were length of hospital stay, complication rates, readmission rates and mortality.

Results: Six randomized controlled trials with 452 patients were included. The number of individual ERAS elements used ranged from 4 to 12, with a mean of 9. The length of hospital stay [weighted mean difference (95% confidence interval): -2.55 (-3.24, -1.85)] and complication rates [relative risk (95% confidence interval): 0.53 (0.44, 0.64)] were significantly reduced in the enhanced recovery group. There was no statistically significant difference in readmission and mortality rates.

Conclusion: ERAS pathways appear to reduce the length of stay and complication rates after major elective open colorectal surgery without compromising patient safety.

Place, publisher, year, edition, pages
Edinburgh, United Kingdom: Churchill Livingstone , 2010. Vol. 29, no 4, p. 434-40
Keywords [en]
Enhanced recovery programs, fast track, meta-analysis, colorectal surgery, outcome, hospital stay, complications, traditional care
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-40284DOI: 10.1016/j.clnu.2010.01.004ISI: 000281270700003PubMedID: 20116145Scopus ID: 2-s2.0-77954936779OAI: oai:DiVA.org:oru-40284DiVA, id: diva2:776762
Available from: 2015-01-08 Created: 2015-01-08 Last updated: 2018-04-24Bibliographically approved

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