Enhanced recovery after surgery in children undergoing abdominal surgery : meta-analysis
Hidayah, Bte Azahari; Toh, Zheng An; Cheng, Ling Jie; Syahzarin, Bin Daud; Zhu, Yi; Pölkki, Tarja; He, Honggu; Mali, Vidyadhar Padmakar (2023-01-20)
Bte Azahari Hidayah, Zheng An Toh, Ling Jie Cheng, Bin Daud Syahzarin, Yi Zhu, Tarja Pölkki, Honggu He, Vidyadhar Padmakar Mali, Enhanced recovery after surgery in children undergoing abdominal surgery: meta-analysis, BJS Open, Volume 7, Issue 1, February 2023, zrac147, https://doi.org/10.1093/bjsopen/zrac147
© The Author(s) 2023. Published by Oxford University Press on behalf of BJS Society Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
https://creativecommons.org/licenses/by-nc/4.0/
https://urn.fi/URN:NBN:fi-fe2023021527283
Tiivistelmä
Abstract
Background: Enhanced recovery after surgery (ERAS) is a multimodal approach that streamlines patient processes before, during, and after surgery. The goal is to reduce surgical stress responses and improve outcomes; however, the impact of ERAS programmes in paediatric abdominal surgery remains unclear. The authors aimed to review the effectiveness of ERAS on clinical outcomes in children undergoing abdominal surgery.
Method: CINAHL, CENTRAL, Embase, ProQuest, PubMed, and Scopus were searched for relevant studies published from inception until January 2021. The length of hospital stay (LOS), time to oral intake, time to stool, complication rates, and 30-day readmissions were measured. Meta-analyses and subgroup analyses were conducted using RevMan 5.4 with a random-effects model.
Results: Among 2371 records from the initial search, 111 articles were retrieved for full-text screening and 12 were included for analyses. The pooled mean difference (MD) demonstrated reduced LOS (MD −1.96; 95 per cent c.i. −2.75 to −1.17), time to oral intake (MD −3.37; 95 per cent c.i. −4.84 to −1.89), and time to stool (MD −4.19; 95 per cent c.i. −6.37 to −2.02). ERAS reduced postoperative complications by half and 30-day readmission by 36 per cent. Subgroup analyses for continuous outcomes suggested that ERAS was more effective in children than adolescents.
Conclusion: ERAS was effective in improving clinical outcomes for paediatric patients undergoing abdominal surgery.
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