Meta-analysis of Enhanced Recovery After Surgery (ERAS) Protocols in Emergency Abdominal Surgery
Objectives To evaluate enhanced recovery after surgery (ERAS) protocols in emergency abdominal surgery. Methods The electronic data sources were explored to capture all studies that evaluated the impact of ERAS protocols in patients who underwent emergency abdominal surgery. The quality of randomise...
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| Veröffentlicht in: | World journal of surgery 2020-05, Vol.44 (5), p.1336-1348 |
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| container_title | World journal of surgery |
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| creator | Hajibandeh, Shahab Hajibandeh, Shahin Bill, Victor Satyadas, Thomas |
| description | Objectives
To evaluate enhanced recovery after surgery (ERAS) protocols in emergency abdominal surgery.
Methods
The electronic data sources were explored to capture all studies that evaluated the impact of ERAS protocols in patients who underwent emergency abdominal surgery. The quality of randomised and non-randomised studies was evaluated by the Cochrane tool and the Newcastle–Ottawa scale, respectively. Random or fixed effects modelling were utilised as indicated.
Results
Six comparative studies, enrolling 1334 patients, were eligible. ERAS protocols resulted in shorter post-operative time to first flatus (mean difference: −1.40,
P
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| doi_str_mv | 10.1007/s00268-019-05357-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2333608355</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2385251615</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4268-f1645cbd366ac8c6ebc87b517cec767fb285bea8d776203ae91895382f7ead743</originalsourceid><addsrcrecordid>eNqNkM1u1DAURi1URIfCC3SBInVTFim2b_wz7KbVtBQVgToglsZxbmiqJJ7ak1bz9nVIW6QuECvb8vk-3XsI2Wf0iFGqPkRKudQ5ZfOcChAqFy_IjBXAcw4cdsiMgizSncEueR3jNaVMSSpfkV1geq7kXM_Iry-4sbntbbuNTcx8nS37K9s7rLJLdP4WwzZb1BsM2WoIv8fX4fJysXqffQt-451vY9b02bLD9Nm7xJaV75pU98i_IS9r20Z8-3DukR-ny-8nn_KLr2fnJ4uL3BXjEjWThXBlBVJap53E0mlVCqYcOiVVXXItSrS6UkpyChbnaQUBmtcKbaUK2COHU-86-JsB48Z0TXTYtrZHP0TDAUBSDUIk9OAZeu2HkGYeKS24YJKNFJ8oF3yMAWuzDk1nw9Ywakb_ZvJvkn_zx78ZQ-8eqoeyw-op8ig8AR8n4K5pcfsflebn59XxKaWgxjBM4ZhyfbL7d_B_zHQPT9Ogfw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2385251615</pqid></control><display><type>article</type><title>Meta-analysis of Enhanced Recovery After Surgery (ERAS) Protocols in Emergency Abdominal Surgery</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>Access via Wiley Online Library</source><creator>Hajibandeh, Shahab ; Hajibandeh, Shahin ; Bill, Victor ; Satyadas, Thomas</creator><creatorcontrib>Hajibandeh, Shahab ; Hajibandeh, Shahin ; Bill, Victor ; Satyadas, Thomas</creatorcontrib><description>Objectives
To evaluate enhanced recovery after surgery (ERAS) protocols in emergency abdominal surgery.
Methods
The electronic data sources were explored to capture all studies that evaluated the impact of ERAS protocols in patients who underwent emergency abdominal surgery. The quality of randomised and non-randomised studies was evaluated by the Cochrane tool and the Newcastle–Ottawa scale, respectively. Random or fixed effects modelling were utilised as indicated.
Results
Six comparative studies, enrolling 1334 patients, were eligible. ERAS protocols resulted in shorter post-operative time to first flatus (mean difference: −1.40,
P
< 0.00001), time to first defecation (mean difference: −1.21,
P
= 0.02), time to first oral liquid diet (mean difference: −2.30,
P
< 0.00001), time to first oral solid diet (mean difference: −2.40,
P
< 0.00001) and length of hospital stay (mean difference: −3.09, −2.80,
P
< 0.00001). ERAS protocols also resulted in lower risks of total complications (odds ratio: 0.50,
P
< 0.00001), major complications (odds ratio: 0.60,
P
= 0.0008), pulmonary complications (odds ratio: 0.38,
P
= 0.0003), paralytic ileus (odds ratio: 0.53, 0.88,
P
= 0.01) and surgical site infection (odds ratio: 0.39,
P
= 0.0001). Both ERAS and non-ERAS protocols resulted in similar risk of 30-day mortality (risk difference: −0.00,
P
= 0.94), need for re-admission (risk difference: −0.01,
P
= 0.50) and need for re-operation (odds ratio: 0.83,
P
= 0.50).
Conclusions
Although ERAS protocols are commonly used in elective settings, they are associated with favourable outcomes in emergency settings as indicated by reduced post-operative complications, accelerated recovery of bowel function and shorter post-operative hospital stay without increasing need for re-admission or re-operation. There should be an effort to incorporate ERAS protocols into emergency abdominal surgery settings.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-019-05357-5</identifier><identifier>PMID: 31897698</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdomen ; Abdomen - surgery ; Abdominal Surgery ; Cardiac Surgery ; Clinical Protocols ; Comparative studies ; Complications ; Defecation ; Diet ; Emergency procedures ; Emergency Treatment ; Enhanced Recovery After Surgery ; General Surgery ; Humans ; Intestine ; Length of Stay ; Medicine ; Medicine & Public Health ; Meta-analysis ; Patients ; Postoperative Complications - prevention & control ; Randomization ; Recovery ; Reoperation - adverse effects ; Risk ; Scientific Review ; Surgery ; Surgical site infections ; Thoracic Surgery ; Vascular Surgery</subject><ispartof>World journal of surgery, 2020-05, Vol.44 (5), p.1336-1348</ispartof><rights>Société Internationale de Chirurgie 2020</rights><rights>2020 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>Société Internationale de Chirurgie 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4268-f1645cbd366ac8c6ebc87b517cec767fb285bea8d776203ae91895382f7ead743</citedby><cites>FETCH-LOGICAL-c4268-f1645cbd366ac8c6ebc87b517cec767fb285bea8d776203ae91895382f7ead743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-019-05357-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-019-05357-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>315,781,785,1418,27926,27927,41490,42559,45576,45577,51321</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31897698$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hajibandeh, Shahab</creatorcontrib><creatorcontrib>Hajibandeh, Shahin</creatorcontrib><creatorcontrib>Bill, Victor</creatorcontrib><creatorcontrib>Satyadas, Thomas</creatorcontrib><title>Meta-analysis of Enhanced Recovery After Surgery (ERAS) Protocols in Emergency Abdominal Surgery</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Objectives
To evaluate enhanced recovery after surgery (ERAS) protocols in emergency abdominal surgery.
Methods
The electronic data sources were explored to capture all studies that evaluated the impact of ERAS protocols in patients who underwent emergency abdominal surgery. The quality of randomised and non-randomised studies was evaluated by the Cochrane tool and the Newcastle–Ottawa scale, respectively. Random or fixed effects modelling were utilised as indicated.
Results
Six comparative studies, enrolling 1334 patients, were eligible. ERAS protocols resulted in shorter post-operative time to first flatus (mean difference: −1.40,
P
< 0.00001), time to first defecation (mean difference: −1.21,
P
= 0.02), time to first oral liquid diet (mean difference: −2.30,
P
< 0.00001), time to first oral solid diet (mean difference: −2.40,
P
< 0.00001) and length of hospital stay (mean difference: −3.09, −2.80,
P
< 0.00001). ERAS protocols also resulted in lower risks of total complications (odds ratio: 0.50,
P
< 0.00001), major complications (odds ratio: 0.60,
P
= 0.0008), pulmonary complications (odds ratio: 0.38,
P
= 0.0003), paralytic ileus (odds ratio: 0.53, 0.88,
P
= 0.01) and surgical site infection (odds ratio: 0.39,
P
= 0.0001). Both ERAS and non-ERAS protocols resulted in similar risk of 30-day mortality (risk difference: −0.00,
P
= 0.94), need for re-admission (risk difference: −0.01,
P
= 0.50) and need for re-operation (odds ratio: 0.83,
P
= 0.50).
Conclusions
Although ERAS protocols are commonly used in elective settings, they are associated with favourable outcomes in emergency settings as indicated by reduced post-operative complications, accelerated recovery of bowel function and shorter post-operative hospital stay without increasing need for re-admission or re-operation. There should be an effort to incorporate ERAS protocols into emergency abdominal surgery settings.</description><subject>Abdomen</subject><subject>Abdomen - surgery</subject><subject>Abdominal Surgery</subject><subject>Cardiac Surgery</subject><subject>Clinical Protocols</subject><subject>Comparative studies</subject><subject>Complications</subject><subject>Defecation</subject><subject>Diet</subject><subject>Emergency procedures</subject><subject>Emergency Treatment</subject><subject>Enhanced Recovery After Surgery</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Intestine</subject><subject>Length of Stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Patients</subject><subject>Postoperative Complications - prevention & control</subject><subject>Randomization</subject><subject>Recovery</subject><subject>Reoperation - adverse effects</subject><subject>Risk</subject><subject>Scientific Review</subject><subject>Surgery</subject><subject>Surgical site infections</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkM1u1DAURi1URIfCC3SBInVTFim2b_wz7KbVtBQVgToglsZxbmiqJJ7ak1bz9nVIW6QuECvb8vk-3XsI2Wf0iFGqPkRKudQ5ZfOcChAqFy_IjBXAcw4cdsiMgizSncEueR3jNaVMSSpfkV1geq7kXM_Iry-4sbntbbuNTcx8nS37K9s7rLJLdP4WwzZb1BsM2WoIv8fX4fJysXqffQt-451vY9b02bLD9Nm7xJaV75pU98i_IS9r20Z8-3DukR-ny-8nn_KLr2fnJ4uL3BXjEjWThXBlBVJap53E0mlVCqYcOiVVXXItSrS6UkpyChbnaQUBmtcKbaUK2COHU-86-JsB48Z0TXTYtrZHP0TDAUBSDUIk9OAZeu2HkGYeKS24YJKNFJ8oF3yMAWuzDk1nw9Ywakb_ZvJvkn_zx78ZQ-8eqoeyw-op8ig8AR8n4K5pcfsflebn59XxKaWgxjBM4ZhyfbL7d_B_zHQPT9Ogfw</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Hajibandeh, Shahab</creator><creator>Hajibandeh, Shahin</creator><creator>Bill, Victor</creator><creator>Satyadas, Thomas</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>202005</creationdate><title>Meta-analysis of Enhanced Recovery After Surgery (ERAS) Protocols in Emergency Abdominal Surgery</title><author>Hajibandeh, Shahab ; Hajibandeh, Shahin ; Bill, Victor ; Satyadas, Thomas</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4268-f1645cbd366ac8c6ebc87b517cec767fb285bea8d776203ae91895382f7ead743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdomen</topic><topic>Abdomen - surgery</topic><topic>Abdominal Surgery</topic><topic>Cardiac Surgery</topic><topic>Clinical Protocols</topic><topic>Comparative studies</topic><topic>Complications</topic><topic>Defecation</topic><topic>Diet</topic><topic>Emergency procedures</topic><topic>Emergency Treatment</topic><topic>Enhanced Recovery After Surgery</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Intestine</topic><topic>Length of Stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Patients</topic><topic>Postoperative Complications - prevention & control</topic><topic>Randomization</topic><topic>Recovery</topic><topic>Reoperation - adverse effects</topic><topic>Risk</topic><topic>Scientific Review</topic><topic>Surgery</topic><topic>Surgical site infections</topic><topic>Thoracic Surgery</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hajibandeh, Shahab</creatorcontrib><creatorcontrib>Hajibandeh, Shahin</creatorcontrib><creatorcontrib>Bill, Victor</creatorcontrib><creatorcontrib>Satyadas, Thomas</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hajibandeh, Shahab</au><au>Hajibandeh, Shahin</au><au>Bill, Victor</au><au>Satyadas, Thomas</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Meta-analysis of Enhanced Recovery After Surgery (ERAS) Protocols in Emergency Abdominal Surgery</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2020-05</date><risdate>2020</risdate><volume>44</volume><issue>5</issue><spage>1336</spage><epage>1348</epage><pages>1336-1348</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Objectives
To evaluate enhanced recovery after surgery (ERAS) protocols in emergency abdominal surgery.
Methods
The electronic data sources were explored to capture all studies that evaluated the impact of ERAS protocols in patients who underwent emergency abdominal surgery. The quality of randomised and non-randomised studies was evaluated by the Cochrane tool and the Newcastle–Ottawa scale, respectively. Random or fixed effects modelling were utilised as indicated.
Results
Six comparative studies, enrolling 1334 patients, were eligible. ERAS protocols resulted in shorter post-operative time to first flatus (mean difference: −1.40,
P
< 0.00001), time to first defecation (mean difference: −1.21,
P
= 0.02), time to first oral liquid diet (mean difference: −2.30,
P
< 0.00001), time to first oral solid diet (mean difference: −2.40,
P
< 0.00001) and length of hospital stay (mean difference: −3.09, −2.80,
P
< 0.00001). ERAS protocols also resulted in lower risks of total complications (odds ratio: 0.50,
P
< 0.00001), major complications (odds ratio: 0.60,
P
= 0.0008), pulmonary complications (odds ratio: 0.38,
P
= 0.0003), paralytic ileus (odds ratio: 0.53, 0.88,
P
= 0.01) and surgical site infection (odds ratio: 0.39,
P
= 0.0001). Both ERAS and non-ERAS protocols resulted in similar risk of 30-day mortality (risk difference: −0.00,
P
= 0.94), need for re-admission (risk difference: −0.01,
P
= 0.50) and need for re-operation (odds ratio: 0.83,
P
= 0.50).
Conclusions
Although ERAS protocols are commonly used in elective settings, they are associated with favourable outcomes in emergency settings as indicated by reduced post-operative complications, accelerated recovery of bowel function and shorter post-operative hospital stay without increasing need for re-admission or re-operation. There should be an effort to incorporate ERAS protocols into emergency abdominal surgery settings.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>31897698</pmid><doi>10.1007/s00268-019-05357-5</doi><tpages>13</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0364-2313 |
| ispartof | World journal of surgery, 2020-05, Vol.44 (5), p.1336-1348 |
| issn | 0364-2313 1432-2323 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2333608355 |
| source | MEDLINE; SpringerNature Journals; Access via Wiley Online Library |
| subjects | Abdomen Abdomen - surgery Abdominal Surgery Cardiac Surgery Clinical Protocols Comparative studies Complications Defecation Diet Emergency procedures Emergency Treatment Enhanced Recovery After Surgery General Surgery Humans Intestine Length of Stay Medicine Medicine & Public Health Meta-analysis Patients Postoperative Complications - prevention & control Randomization Recovery Reoperation - adverse effects Risk Scientific Review Surgery Surgical site infections Thoracic Surgery Vascular Surgery |
| title | Meta-analysis of Enhanced Recovery After Surgery (ERAS) Protocols in Emergency Abdominal Surgery |
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