Liu Feiyu, Wang Wei, Wang Chengde, Peng Xiaonu
Department of Pharmacy Department of Thoracic Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Medicine (Baltimore). 2018 Feb;97(8):e0016. doi: 10.1097/MD.0000000000010016.
Esophageal cancer is one of the worst malignant digestive neoplasms with poor treatment outcomes. Esophagectomy plays an important role and offers a potential curable chance to these patients. However, esophagectomy with radical lymphadenectomy is known as one of the most invasive digestive surgeries which are associated with high morbidity and mortality. The enhanced recovery after surgery (ERAS) protocol is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition, and psychology, which is designed for reducing complications, promoting recovery, and improving treatment outcomes. This systematic review and meta-analysis is aiming at how beneficial, and to what extent ERAS really will be.
A systematic literature search will be performed through January 2018 using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and Google Scholar for relevant articles published in any language. Randomized controlled trials, prospective cohort studies, and propensity-matched comparative studies will be included. All meta-analyses will be performed using Review Manager software. The quality of the studies will be evaluated using the guidelines listed in the Cochrane Handbook. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statements will be followed until the findings of the systematic review and meta-analysis are reported.
The results of this systematic review and meta-analysis will be published in a peer-reviewed journal.
Our study will draw an objective conclusion of the comparisons between ERAS and conventional care in aspects of perioperative outcomes and provide level I evidences for clinical decision makings.
食管癌是最严重的恶性消化系统肿瘤之一,治疗效果不佳。食管切除术起着重要作用,为这些患者提供了潜在的治愈机会。然而,食管切除术加根治性淋巴结清扫术是最具侵入性的消化系统手术之一,与高发病率和死亡率相关。术后加速康复(ERAS)方案是以患者为中心、由外科医生主导的系统,结合了麻醉、护理、营养和心理等方面,旨在减少并发症、促进康复并改善治疗效果。本系统评价和荟萃分析旨在探讨ERAS到底有多有益以及在何种程度上有益。
将通过检索MEDLINE、EMBASE、Cochrane对照试验中央注册库以及Google Scholar,对截至2018年1月以任何语言发表的相关文章进行系统的文献检索。纳入随机对照试验、前瞻性队列研究和倾向匹配比较研究。所有荟萃分析将使用Review Manager软件进行。将根据Cochrane手册中列出的指南评估研究质量。在报告系统评价和荟萃分析的结果之前,将遵循系统评价和荟萃分析的首选报告项目声明。
本系统评价和荟萃分析的结果将发表在同行评审期刊上。
我们的研究将对ERAS与传统护理在围手术期结局方面的比较得出客观结论,并为临床决策提供一级证据。