Enhanced recovery after surgery (ERAS) protocols is extermely beneficial in liver surgeries. A metaanalysis.

Abstract

BACKGROUND: Enhanced recovery after surgery (ERAS) programs aim to improve postoperative outcomes.. This metaanalysis aims to evaluate the impact of ERAS programmes on outcomes following liver surgeries. METHODS: EMBASE, MEDLINE, PubMed and the Cochrane Database were searched for studies comparing outcomes in patients undergoing liver surgery utilizing ERAS principles with those patients receiving conventional care. The primary outcome was occurrence of 30 day morbidity and mortality. Secondary outcomes included length of stay , functional recovery ,readmission rates,time to pass flatus,blood loss and hospital costs. RESULTS: Ten articles were included in the metaanalysis. Overall 30 days mortality rates were 0.65% in ERAS group while 0.97% in standard group (p=0.997). 30 days morbidity rates were not different in ERAS group compared to conventional care patients. (20.2 % in ERAS vs. 25 % in non ERAS). (p=0.329).Hospital stay, time to pass flatus, time to complete recovery and hospital costs were also significantly reduced due to ERAS protocols. (p value <0.001 ,0.005,<0.001,and 0.038 respectively ). There was no significant difference in blood loss and readmission rates between the two groups. (p=0.594, and 0.916 respectively) CONCLUSIONS: The adoption of ERAS protocols significantly reduced morbidity, hospital stay, readmission rates, time to recovery, hospital costs, time to pass flatus. There were no significant differences in 30 day mortality and blood loss. KEYWORDS: Enhanced recovery after surgery, liver surgery, HPB surgery, morbidity, mortality, liver resection, fast track surgery.