Abstract
The study aimed to produce a comprehensive up-to-date meta-analysis exploring the safety and efficacy of enhanced recovery (ER) programmes after colorectal resection.
Key-word and MESH-heading searches of MEDLINE, EMBASE and the Cochrane Databases from 1966 to February 2007 were used to identify all available randomized and clinical controlled studies. Two independent reviewers assessed studies for inclusion and exclusion based on methodological quality criteria prior to undertaking data extraction. Summary estimates of treatment effects using a fixed effect model were produced with RevMan 1.0.2, using weighted means for length-of-stay data and relative risks of morbidity, mortality and readmission rates.
Analysis of four papers including 376 patients demonstrated primary and total length-of-stays (primary + readmission length-of-stay) to be significantly reduced (P < 0.001) with ER programmes [weighted mean differences of -3.64 days (95% confidence interval, 95% CI -4.98 to -2.29) and -3.75 days (95% CI-5.11 to -2.40)]. Analysis of controlled clinical trial data showed morbidity rates to be reduced and readmission rates increased. These trends were not seen amongst the randomized controlled trial data. There were no differences in mortality rates.
Enhanced recovery programmes after colorectal resections reduce length-of-stay and may reduce 30 days morbidity and increase 30 days readmission without increasing mortality.
| Original language | English |
|---|---|
| Pages (from-to) | 344-353 |
| Number of pages | 10 |
| Journal | Colorectal Disease |
| Volume | 11 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - May 2009 |
Keywords
- Enhanced recovery
- colorectal surgery
- systematic review and meta-analysis
- MULTIMODAL REHABILITATION PROGRAM
- RANDOMIZED CLINICAL-TRIAL
- FAST-TRACK SURGERY
- COLONIC RESECTION
- CONVENTIONAL CARE
- SURGICAL CARE
- SIGMOIDECTOMY
- OPTIMIZATION
- PATHWAY
- STAY