Application of enhanced recovery after gastric cancer surgery: An updated meta-analysis

Table 3 Evaluation of the complications or outcomes in enhanced recovery after surgery vs standard care groups in the included studies

Subgroup	Studies, n	Participants, n	Statistical method	Effect estimate	Heterogeneity
					I2	P value
Total complications	13	1092	Risk ratio (M-H, random, 95%CI)	1.03 [0.73, 1.44]	75%	< 0.00001
Anastomotic leak	10	964	Risk ratio (M-H, random, 95%CI)	1.36 [0.54, 3.45]	0	0.50
Ileus	12	1048	Risk ratio (M-H, random, 95%CI)	1.62 [0.75, 3.52]	0	0.57
Incision infection	11	1007	Risk ratio (M-H, random, 95%CI)	0.79 [0.39, 1.60]	0	0.87
Urinary tract infection	9	699	Risk ratio (M-H, random, 95%CI)	0.53 [0.26, 1.08]	0	0.99
Pulmonary infection	9	775	Risk ratio (M-H, random, 95%CI)	0.52 [0.28, 0.94]	0	0.99
Postoperative hospital stay	13	1092	Mean difference (IV, random, 95%CI)	-1.65 [-2.09, -1.21]	89%	< 0.00001
Duration of first flatus	11	882	Mean difference (IV, random, 95%CI)	-12.70 [-19.71, -5.69]	92%	< 0.00001
Duration of first defecation	4	471	Mean difference (IV, random, 95%CI)	-28.07 [-41.48, -14.67]	90%	< 0.00001
Medical costs	10	819	Mean difference (IV, random, 95%CI)	-0.50 [-0.69, -0.30]	85%	< 0.00001
CRP
POD1	8	514	Mean difference (IV, random, 95%CI)	-14.81 [-21.42, -8.21]	72%	0.0007
POD4	6	378	Mean difference (IV, random, 95%CI)	-19.81 [-29.64, -9.98]	64%	0.02
POD7	5	258	Mean difference (IV, random, 95%CI)	-21.36 [-28.81, -13.91]	74%	0.004
IL-6
POD1	4	239	Mean difference (IV, random, 95%CI)	-61.22 [-114.58, -7.86]	99%	< 0.00001
POD4	3	147	Mean difference (IV, random, 95%CI)	-31.50 [-55.63, -7.38]	96%	< 0.00001
POD7	3	176	Mean difference (IV, random, 95%CI)	-26.62 [-34.23, -19.01]	89%	0.0001
ALB
POD1	2	84	Mean difference (IV, random, 95%CI)	0.24 [-0.89, 1.36]	0	0.79
POD4	4	166	Mean difference (IV, random, 95%CI)	3.27 [2.24, 4.30]	23%	0.27
POD7	4	166	Mean difference (IV, random, 95%CI)	5.68 [3.31, 8.05]	83%	0.0005
Readmission	8	777	Risk ratio (M-H, Fixed, 95%CI)	2.86 [1.31, 6.24]	0	0.92
Reoperation	3	517	Risk ratio (M-H, Fixed, 95%CI)	0.62 [0.17, 2.35]	33%	0.22
Quality of life	2	136	Std. mean difference (IV, Fixed, 95%CI)	-0.46 [-0.80, -0.12]	36%	0.21

ALB: Serum albumin; CRP: C-reactive protein; IL-6: Interleukin-6; IV: Inverse Variance; M-H: Mantel-Haenszel; POD: Postoperative day.