Fast-track recovery after major liver and pancreatic resection utilizing the ERAS approaches: A meta-analysis

Abstract

Abstract
Background: Enhanced Recover After Surgery (ERAS) is a multidisciplinary multimodal approach used to treat surgical patients, which targets perioperative management optimization of results. This approach was first applied to patients who had undergone colorectal surgery. However, its application on pancreatoduodenectomy patients is limited. Currently numerous studies conducted around ERAS for pancreaticoduodenectomy patients have been published. This study collected data comprehensively in order to indicate the best indication summary for the clinic.
Objective: With the help of this study, the practicality and safety of the ERAS approach was assessed in terms of recovery after surgery in the pancreatoduodenectomy patient at the time of the perioperative supervision.
Methods: Literature searches were conducted in databases such as Embase, Cochrane, and PubMed online databases, published up until July 2020. Case-control studies and randomized controlled trials (RCTs) that applied ERAS for pancreaticoduodenectomy patients were included. The patients were divided into two parts: the ERAS group and the control group. Revman 5.3 software and R software were utilized for all statistical analyses. The results were calculated as weighted mean differences or odds ratios with a 95% confidence interval for publication bias assessment funnel plots. Sensitivity and subgroup analyses were performed to investigate the source of heterogeneity.
Results: A total of 3613 patients from 20 studies (1699 control group patients vs. 1914 ERAS group patients) were included in the study. Among the 20 studies, 16 studies were case-control, and 4 were RCTs . The results indicated that, ERAS approached patients suffered less from postoperative complications as compared to the control group. ERAS group patients had fewer gastric symptoms, and they also had less hospital stay.
Conclusion: It has been found that the ERAS treatment method is highly beneficial and safe for treating pancreatoduodenectomy patients. This method results in a speedy recovery as compared to the other methods.[Ethiop. J. Health Dev. 2021;35(4): 344-348]
Keywords: ERAS, Pancreatoduodenectomy, Surgical patients, Fast-track recovery.