术后加速康复（ERAS）方案在急诊腹腔内手术后的应用：系统评价和荟萃分析方案。
Enhanced Recovery After Surgery (ERAS) protocols following emergency intra-abdominal surgery: A systematic review and meta-analysis protocol.
机构信息
Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
出版信息
PLoS One. 2023 Sep 8;18(9):e0291140. doi: 10.1371/journal.pone.0291140. eCollection 2023.
OBJECTIVE
The aim of this systematic review and meta-analysis is to evaluate whether the implementation of Enhanced Recovery After Surgery (ERAS) protocols for adult patients undergoing emergency intra-abdominal surgery decreases postoperative length of stay, postoperative morbidity, and mortality compared to conventional perioperative care.
METHODS
A systematic review and meta-analysis will be performed and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). It has been registered on the International Prospective Register for Systematic Reviews (PROSPERO; CRD42023391709). A comprehensive, electronic search strategy will be used to identify studies published and indexed in MEDLINE, EMBASE, Web of Science, CENTRAL, and Pubmed databases since their inception. Trial registries and references of included studies and pertinent previous systematic reviews will also be searched. Studies will be included if they are randomized controlled trials or cohort studies evaluating adult patients undergoing emergency intra-abdominal surgery and comparing ERAS or modified ERAS protocols to conventional perioperative care and report one of the following outcomes: postoperative length of stay, overall 30-day morbidity, 30-day mortality, 30-day infectious morbidity, prolonged postoperative ileus, return of bowel function, and 30-day readmissions. A meta-analysis will be performed using a random effects model for all comparative data using Cochrane Review Manager 5.3 (London, United Kingdom).
DISCUSSION
ERAS protocols have become standard of care for patients undergoing elective surgery. Their use in the setting of emergency surgery is far less common. The aim of this systematic review and meta-analysis is to assess whether there are benefits in patient important outcomes with the implementation of ERAS protocols for patients undergoing emergency intra-abdominal surgery. Ultimately, we hope to promote their use and further large randomized controlled trials evaluating emergency surgery ERAS programs.
PROSPERO REGISTRATION NUMBER
CRD42023391709.
目的
本系统评价和荟萃分析的目的是评估成人急诊腹部手术中实施增强术后恢复（ERAS）方案是否与常规围手术期护理相比，降低术后住院时间、术后发病率和死亡率。
方法
将按照系统评价和荟萃分析的首选报告项目（PRISMA）进行系统评价和荟萃分析，并进行报告。该研究已在国际前瞻性系统评价登记处（PROSPERO；CRD42023391709）注册。将使用全面的电子搜索策略来确定自成立以来在 MEDLINE、EMBASE、Web of Science、CENTRAL 和 Pubmed 数据库中发表和索引的研究。还将搜索纳入研究的试验登记处和参考文献以及相关的先前系统评价。如果研究是评估接受急诊腹部手术的成年患者的随机对照试验或队列研究，并且将 ERAS 或改良 ERAS 方案与常规围手术期护理进行比较，并报告以下结果之一，则将纳入研究：术后住院时间、总 30 天发病率、30 天死亡率、30 天感染发病率、术后肠麻痹延长、肠功能恢复和 30 天再入院。将使用 Cochrane Review Manager 5.3（英国伦敦）对所有比较数据进行随机效应模型的荟萃分析。
讨论
ERAS 方案已成为接受择期手术患者的标准护理。在急诊手术中使用它们的情况要少得多。本系统评价和荟萃分析的目的是评估在接受急诊腹部手术的患者中实施 ERAS 方案是否在患者重要结局方面有获益。最终，我们希望促进它们的使用，并进一步开展评估急诊手术 ERAS 方案的大型随机对照试验。
PROSPERO 注册号：CRD42023391709。
Zotero 插件