Department of Anesthesiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Surgical Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
J Laparoendosc Adv Surg Tech A. 2024 Aug;34(8):710-720. doi: 10.1089/lap.2024.0119. Epub 2024 Jul 8.
The primary objective of this study was to evaluate the safety and efficacy of the enhanced recovery after surgery (ERAS) protocol in cholecystectomy, comparing it with standard care. A comprehensive literature search was conducted in December 2023, using globally recognized databases such as PubMed, Embase, and the Cochrane Library. Various parameters were compared using Review Manager software. This study was duly registered with PROSPERO (CRD420223). The meta-analysis included nine studies, encompassing a total of 1920 patients. The findings revealed that the ERAS group, in comparison to traditional care, experienced shorter hospitalization periods (weighted mean difference [WMD]: -1.23, 95% confidence interval [CI]: -1.98 to -0.47; = .001), lower visual analog scale at 24 hours (WMD: -1.10, 95% CI: -1.30 to -0.90; < .00001), faster time to first flatus (WMD: -4.48, 95% CI: -4.50 to -4.46; < .00001), and reduced operative times (WMD: -9.94, 95% CI: -17.88 to -0.96; = .03). In addition, there was a notable decrease in instances of postoperative nausea and vomiting (odds ratio [OR]: 0.46, 95% CI: 0.28 to 0.74; = .002). No significant differences were observed in readmission rates, blood loss, postoperative complications, or bile leakage between the two care methods. This study substantiates that the ERAS protocol is an advantageous perioperative care strategy for patients undergoing cholecystectomy. It significantly outperforms traditional care in reducing the length of stay, decreasing the likelihood of postoperative nausea/vomiting, alleviating postoperative pain, and accelerating the time to the first flatus. These findings highlight the effectiveness of ERAS in enhancing patient outcomes in cholecystectomy.
本研究的主要目的是评估围手术期加速康复（ERAS）方案在胆囊切除术中的安全性和疗效，并将其与标准护理进行比较。我们于 2023 年 12 月进行了全面的文献检索，使用了全球认可的数据库，如 PubMed、Embase 和 Cochrane Library。使用 Review Manager 软件比较了各种参数。本研究已在 PROSPERO（CRD420223）上注册。该荟萃分析纳入了 9 项研究，共纳入 1920 例患者。研究结果表明，与传统护理相比，ERAS 组患者的住院时间更短（加权均数差 [WMD]：-1.23，95%置信区间 [CI]：-1.98 至-0.47； =.001），术后 24 小时视觉模拟评分更低（WMD：-1.10，95%CI：-1.30 至-0.90； <.00001），首次排气时间更快（WMD：-4.48，95%CI：-4.50 至-4.46； <.00001），手术时间更短（WMD：-9.94，95%CI：-17.88 至-0.96； =.03）。此外，术后恶心和呕吐的发生率显著降低（比值比 [OR]：0.46，95%CI：0.28 至 0.74； =.002）。两种护理方法的再入院率、出血量、术后并发症或胆漏发生率无显著差异。本研究证实，ERAS 方案是胆囊切除术患者围手术期有利的护理策略。与传统护理相比，它在缩短住院时间、降低术后恶心/呕吐的可能性、减轻术后疼痛和加速首次排气时间方面具有显著优势。这些发现强调了 ERAS 在改善胆囊切除术患者结局方面的有效性。
