ERAS Protocols for Thyroid and Parathyroid Surgery: A Systematic Review and Meta-analysis

Area of Science:

• Endocrinology
• Surgical Oncology
• Perioperative Medicine

Background:

• Enhanced Recovery After Surgery (ERAS) protocols are evidence-based programs to optimize perioperative care and patient recovery.
• The application and efficacy of ERAS protocols in thyroid and parathyroid surgery are not well-established.
• Limited evidence exists regarding the clinical benefits and cost-effectiveness of ERAS in these specific surgical procedures.

Purpose of the Study:

• To investigate the clinical benefits of ERAS protocols in patients undergoing thyroidectomy and parathyroidectomy.
• To evaluate the cost-effectiveness of implementing ERAS protocols for these endocrine surgeries.
• To synthesize current evidence on ERAS protocol effectiveness in thyroid and parathyroid surgery.

Main Methods:

• A systematic review of multiple databases (Medline, Scopus, Embase) and gray literature was conducted.
• Studies were screened by two independent reviewers based on predefined inclusion criteria.
• Meta-analysis was used to compare outcomes between ERAS and standard care groups, focusing on length of stay, costs, readmissions, and complications.

Main Results:

• Seven studies with 3082 patients met the inclusion criteria.
• ERAS protocols were associated with a significant reduction in hospital length of stay (mean difference: -0.64 days).
• Hospital costs were also reduced (mean difference: -$307.70), with no significant increase in readmission or complication rates.

Conclusions:

• Growing evidence supports the use of ERAS protocols in perioperative management for thyroidectomy and parathyroidectomy.
• ERAS protocols demonstrate significant reductions in hospital length of stay and costs.
• These protocols can be safely implemented without adversely affecting complication or readmission rates.