摘要
AIMToprovideanupdatedassessmentofthesafetyandefficacyofenhancedrecoveryaftersurgery(ERAS)protocolsinelectivegastriccancer(GC)surgery.METHODSPubMed,Medline,EMBASE,WorldHealthOrganizationInternationalTrialRegister,andCochraneLibraryweresearcheduptoJune2017forallavailablerandomizedcontrolledtrials(RCTs)comparingERASprotocolsandstandardcare(SC)inGCsurgery.ThirteenRCTs,withatotalof1092participants,wereanalyzedinthisstudy,ofwhom545underwentERASprotocolsand547receivedSCtreatment.RESULTSNosignificantdifferencewasobservedbetweenERASandcontrolgroupsregardingtotalcomplications(P=0.88),mortality(P=0.50)andreoperation(P=0.49).Theincidenceofpulmonaryinfectionwassignificantlyreduced(P=0.03)followinggastrectomy.However,thereadmissionrateafterGCsurgerynearlytripledunderERAS(P=0.009).ERASprotocolssignificantlydecreasedthelengthofpostoperativehospitalstay(P<0.00001)andmedicalcosts(P<0.00001),andacceleratedbowelfunctionrecovery,asmeasuredbyearliertimetothefirstflatus(P=0.0004)andthefirstdefecation(P<0.0001).Moreover,ERASprotocolswereassociatedwithalowerlevelofseruminflammatoryresponse,higherserumalbumin,andsuperiorshorttermqualityoflife(QOL).CONCLUSIONCollectively,ERASresultsinacceleratedconvalescence,reductionofsurgicalstressandmedicalcosts,improvednutritionalstatus,andbetterQOLforGCpatients.However,high-qualitymulticenterRCTswithlargesamplesandlong-termfollow-upareneededtomorepreciselyevaluateERASinradicalgastrectomy.
出版日期
2018年12月22日（中国期刊网平台首次上网日期，不代表论文的发表时间）
