The enhanced recovery after surgery (ERAS) pathway for patients undergoing major elective open colorectal surgery: a meta-analysis of randomized controlled trials.

K.K. Varadhan, K.R. Neal, C.H. Dejong, K.C. Fearon, O. Ljungqvist, D.N. Lobo

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BACKGROUND & AIMS: The aim of the Enhanced Recovery After Surgery (ERAS) pathway is to attenuate the stress response to surgery and enable rapid recovery. The objective of this meta-analysis was to study the differences in outcomes in patients undergoing major elective open colorectal surgery within an ERAS pathway and those treated with conventional perioperative care. METHODS: Medline, Embase and Cochrane database searches were performed for relevant studies published between January 1966 and November 2009. All randomized controlled trials comparing ERAS with conventional perioperative care were selected. The outcome measures studied were length of hospital stay, complication rates, readmission rates and mortality. RESULTS: Six randomized controlled trials with 452 patients were included. The number of individual ERAS elements used ranged from 4 to 12, with a mean of 9. The length of hospital stay [weighted mean difference (95% confidence interval): -2.55 (-3.24, -1.85)] and complication rates [relative risk (95% confidence interval): 0.53 (0.44, 0.64)] were significantly reduced in the enhanced recovery group. There was no statistically significant difference in readmission and mortality rates. CONCLUSION: ERAS pathways appear to reduce the length of stay and complication rates after major elective open colorectal surgery without compromising patient safety.
Original languageEnglish
Pages (from-to)434-440
Number of pages7
JournalClinical Nutrition
Volume29
Issue number4
DOIs
Publication statusPublished - Aug 2010

Keywords

  • Enhanced recovery programs
  • Fast track
  • Meta-analysis
  • Colorectal surgery
  • Outcome
  • Hospital stay
  • Complications
  • Traditional care
  • FAST-TRACK
  • MULTIMODAL OPTIMIZATION
  • POSTOPERATIVE CARE
  • CLINICAL-TRIALS
  • HOSPITAL STAY
  • RESECTION
  • PROTOCOL
  • STANDARD
  • PROGRAM

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