Meta-Analysis of Enhaced Recovery After Ssurgery Protocols for the Perioperative Management of Pediatric Colorectal Surgery

Topic overview

New article you should know! From Journal of Pediatric Surgery by Dr. Cecilia Gigena

"Meta-Analysis of Enhaced Recovery After Ssurgery Protocols for the Perioperative Management of Pediatric Colorectal Surgery” 

Authors: Yingchun Su, Lu Xu, Jinhui Hu, Jiayinaxi Musha, Song Lin

Full article: https://gcmd.co/3RRiwul

Objective

This meta-analysis aimed to investigate the effects and safety of enhanced recovery after surgery (ERAS) for the management of pediatric colorectal surgery.

Methods

We retrieved relevant studies from PubMed, EMBASE, the Cochrane Library, and China National Knowledgement Infrastructure (CNKI) from its inception until 20 May 2022. Meta-analysis was performed using RevMan 5.4, and power analysis was calculated using G∗Power 3.1.

Results

Ten studies involving 1298 patients were included for meta-analysis. Meta-analysis suggested that ERAS protocol significantly lessened intraoperative fluids (mean difference [MD], −3.11; 95% confidence interval, −4.99 to −1.22) and postoperative opioid usage (MD, −0.58; 95% CI, −1.08 to −0.26), shortened time to bowel return (MD, −12.02; 95% CI, −20.03 to −4.02), first enteral nutrition (MD, −20.88; 95% CI, −28.34 to −13.42) and oral intake (MD, −1.40; 95% CI, −1.96 to −0.84), lowered readmission rate in 30 days (relative risk [RR], 0.61, 95% CI, 0.41 to 0.90), shortened length of hospital stay (MD, −1.50; 95% CI, −1.25 to −1.09), and reduced in-hospital costs (MD, −0.26; 95% CI, −0.34 to −0.18); however, there was a comparable rate of postoperative complications between the two groups. Sensitivity analysis significantly changed the result of the readmission rate in 30 days. The statistical power of all outcomes ranged from 26.84% to 99.44%.

Conclusions

Our findings demonstrate the beneficial role of the ERAS protocol in accelerating rehabilitation, shortening the length of hospital stay, and decreasing in-hospital costs among pediatric patients undergoing colorectal surgery.

Intended audience: Healthcare professionals and clinicians.