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Enhanced Recovery After Surgery (ERAS) in Gynaecology: a meta-analysis
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  • Zixuan Song,
  • Yizi Wang,
  • Dandan Zhang,
  • Yangzi Zhou
Zixuan Song
Shengjing Hospital of China Medical University
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Yizi Wang
Shengjing Hospital of China Medical University
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Dandan Zhang
Shengjing Hospital of China Medical University
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Yangzi Zhou
Shengjing Hospital of China Medical University
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Abstract

Background Enhanced recovery after surgery (ERAS), which originated in colorectal surgery, has been implemented in different types of surgery, but its effectiveness in gynaecologic surgery remains to be determined. Objectives A meta-analysis was conducted on the existing studies to compare the effects of ERAS pathways and routine management on the outcomes of gynaecological surgeries. Search Strategy The main database was retrieved from inception to 24 July 2020 using the term ‘enhanced recovery after surgery’ and its changes, as well as search restrictions for related study designs. Selection Criteria Studies whose number of ERAS pathways projects implemented by the ERAS group but not by the conventional surgery group was no less than four were included. Outcomes included length of hospital stay, complications, and so on. Data Collection and Analysis According to the accurate data extraction table, the fixed or random effects model was used to summarize. Main Results The length of hospital stay (LOS) situation of the ERAS group was significantly shorter than that of the control group, including the shortening of primary LOS (SMD=-0.681, 95% CI: -0.844–0.517, P<0.01) and total LOS (SMD=-0.312, 95% CI: -0.551–0.073, P=0.011), as well as the increase of the number of people reaching the target LOS (OR=4.899, 95% CI: 3.825-6.276, P<0.01). Conclusions The available evidence suggests that ERAS pathways may reduce the length of postoperative hospital stay in gynaecologic surgery, without increasing complications, while shortening the time needed for postoperative functional recovery. Keywords Enhanced recovery after surgery, ERAS, gynaecology