Abstract
BackgroundThe study aimed to compare the safety and effectiveness of Enhanced recovery after surgery (ERAS) with conventional care in gastrectomy for gastric cancer.MethodsSearch strategy from Pubmed, Embase, Web of science, Cochrane library and reference lists was performed. The collected studies were randomized controlled trials and published only in English, and undergoing ERAS in gastrectomy for gastric cancer from January 1994 to August 2016.ResultsA total of eight studies including 801 patients were included. There were 399 cases in the ERAS and 402 cases in the conventional care groups. Meta-analysis showed that time to first passage of flatus (weighted mean difference (WMD) -14.57; 95% confidence interval (CI) -20.31 to -8.83, p<0.00001), level of C-reaction protein (WMD -19.46; 95 % CI -21.74 to -17.18, p<0.00001) and interleukin-6 (WMD-32.16; 95 % CI -33.86 to -30.46,p<0.00001) on postoperative days, postoperative hospital stay (WMD -1.85; 95 % CI -2.35 to -1.35, p<0.00001), hospital charge (WMD −0.94, 95 % CI, −1.40 to 0.49, p<0.0001) were significantly decreased for ERAS, but increased readmission rates (odds ratio (OR), 3.42, 95 % CI, 1.43 to 8.21, P=0.006). There were no statistically significant differences in intraoperative blood loss, operation time, number of retrieved lymph nodes, duration of foley catheter and postoperative complications (p>0.05).ConclusionsERAS is considered to be safe and effective in gastrectomy for gastric cancer. Further larger, multicenter and randomized trials were needed to beresearched.
Highlights
Gastric cancer is the fourth most common cancer and the third leading cause of cancer related deaths in the world [1], especially in Eastern Asia, Central and Eastern Europe, and South America [2]
8 articles were included for the meta-analysis (Figure 1)
Our study aimed to evaluate the safety and effectiveness of Enhanced recovery after surgery (ERAS) in gastric cancer patients undergoing gastrectomy compared to the conventional care
Summary
Gastric cancer is the fourth most common cancer and the third leading cause of cancer related deaths in the world [1], especially in Eastern Asia, Central and Eastern Europe, and South America [2]. The ERAS working group developed [15] and modified the consensus guidelines for ERAS programs in 2009 [16] These programs addressed 20 issues which included preadmission counseling, preoperative preparation, www.impactjournals.com/oncotarget standard anesthetic protocol, postoperative care and so on. We performed a meta-analysis to systematically describe the feasibility and safety of ERAS in patients undergoing gastrectomy for gastric cancer compared with conventional care. This meta-analysis was performed in line with the recommendations of the preferred reporting items for systematic reviews and metaanalyses (PRISMA) statement (Supplemental Table 1) [17]. The study aimed to compare the safety and effectiveness of Enhanced recovery after surgery (ERAS) with conventional care in gastrectomy for gastric cancer
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