Fast track for open hepatectomy: A systemic review and meta-analysis

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Evidence-Based Medicine

Background:

• Liver resection (LR) is a primary treatment for liver malignancies and benign masses.
• The fast track (FT) program aims to enhance functional recovery and reduce hospital length of stay (LoS) in abdominal surgery.
• Evaluating the impact of FT programs specifically for patients undergoing liver resection is crucial.

Purpose of the Study:

• To meta-analyze the efficacy of the fast track (FT) program in patients following liver resection (LR).
• To assess the impact of FT on complication rates, mortality, readmission, and LoS after LR.

Main Methods:

• A systematic literature search was conducted across PubMed/Medline, CENTRAL, and Embase up to December 2015.
• Included studies compared FT programs with conventional care in liver resection patients.
• Outcomes assessed included complication rates, 30-day mortality, readmission rates, and LoS.

Main Results:

• The meta-analysis synthesized data from 4 RCTs and 3 CTs, totaling 1027 patients.
• FT programs significantly reduced LoS by 2.24 days (P < 0.005).
• While overall complication, mortality, and readmission rates showed no significant difference, FT favored a reduction in general complications (RR, 0.68; P = 0.03).

Conclusions:

• The FT program is a safe and effective strategy for liver resection (LR).
• FT significantly shortens hospital length of stay (LoS) and accelerates postoperative recovery.
• FT does not increase mortality, morbidity, or readmission rates following liver resection.