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