Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 16, 2022; 10(11): 3426-3435
Published online Apr 16, 2022. doi: 10.12998/wjcc.v10.i11.3426
Effect of enhanced recovery after surgery on inflammatory bowel disease surgery: A meta-analysis
Dong Peng, Yu-Xi Cheng, Wei Tao, Hua Tang, Guang-Yan Ji
Dong Peng, Yu-Xi Cheng, Wei Tao, Hua Tang, Guang-Yan Ji, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Author contributions: Tang H and Ji GY are co-corresponding authors; Peng D, Tang H and Ji GY contributed to the quality assessments; Cheng YX and Tao W contributed to data extraction; Peng D, Tao W and Cheng YX contributed to data analysis; Peng D contributed to writing the original draft; Peng D, Tang H and Ji GY contributed to writing and editing; All authors read and approved the final manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Guang-Yan Ji, PhD, Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuanjiagang District, Chongqing 400016, China. jiguangyan168@163.com
Received: August 20, 2021
Peer-review started: August 20, 2021
First decision: November 11, 2021
Revised: November 12, 2021
Accepted: February 27, 2022
Article in press: February 27, 2022
Published online: April 16, 2022
Processing time: 230 Days and 20.8 Hours
Abstract
BACKGROUND

The purpose of enhanced recovery after surgery (ERAS) was to reduce surgical pressure and accelerate postoperative functional recovery. Although the application of biologics in treating inflammatory bowel disease (IBD) has changed treatment strategies, most patients with IBD still require surgery.

AIM

To evaluate the advantage of ERAS in IBD surgery.

METHODS

The PubMed, EMBASE and Cochrane Library databases were searched from inception to March 21, 2021 to find eligible studies. The primary outcome was postoperative complications, and the secondary outcomes included operation time, time to first flatus, time to bowel movement, postoperative hospital stay and readmission. The PROSPERO registration ID of this meta-analysis is CRD42021238052.

RESULTS

A total of eight studies involving 1939 patients were included in this meta-analysis. There were no differences in baseline information between the ERAS group and the non-ERAS group. After pooling up all of the data, no significant difference was found between the ERAS group and the non-ERAS group in terms of postoperative overall complications [odds ratio = 0.82, 95% confidence interval (CI) = 0.66 to 1.02, P = 0.08]. The ERAS group had a lower prevalence of anastomotic fistula (odds ratio = 0.36, 95%CI = 0.13 to 0.95, P = 0.04), less time to first flatus [mean difference (MD) = -2.03, 95%CI = -3.89 to -0.17, P = 0.03], less time to bowel movement (MD = -1.08, 95%CI = -1.60 to -0.57, P < 0.01) and shorter postoperative hospital stays (MD = -1.99, 95%CI = -3.27 to -0.71, P < 0.01) than the non-ERAS group.

CONCLUSION

ERAS was effective for the quicker recovery in IBD surgery and did not lead to increased complications.

Keywords: Enhanced recovery after surgery; Inflammatory bowel disease; Meta-analysis

Core Tip: The purpose of this meta-analysis was to evaluate the safety and efficacy of enhanced recovery after surgery in inflammatory bowel disease surgery. In conclusion, enhanced recovery after surgery was effective for the quicker recovery in inflammatory bowel disease surgery and did not lead to increased complications.