Meta-analysis for the evaluation of perioperative enhanced recovery after gynaecological surgery

To systematically evaluate the effectiveness and safety of enhanced recovery after surgery (ERAS) in gynaecological surgery and provide a scientific basis for its clinical promotion and application in the Chinese population.

Systematic retrieval from CNKI, Wanfang, VIP database and other Chinese literature databases. Studies on ERAS application with a randomised controlled trial in gynaecological surgery were included in the present report. Outcome indicators: hospitalisation time, postoperative ambulation time, postoperative feeding time, postoperative exhaust time, postoperative defecation time, operation time, postoperative blood loss, postoperative morbidity, patient satisfaction, hospitalisation expenses, etc. The meta-analysis was performed using the Revman 5.3 software.

A total of 24 studies were included in the analysis. The results showed that, compared with the traditional group, the ERAS group had a lower hospitalisation time (SMD = -1.67, 95% CI = -2.03 ~ -1.30, p < 0.0001), postoperative ambulation time (SMD = -4.16, 95% CI = -5.12 ~ -3.20, p < 0.0001), postoperative feeding time (SMD = -7.36, 95% CI = -9.67 ~ -5.05, p < 0.0001), postoperative exhaust time (SMD = -2.59, 95% CI = -3.15 ~ -2.03, p < 0.0001), postoperative defecation time (SMD = -2.23, 95% CI = -2.88 ~ -1.57, p < 0.0001), postoperative morbidity (OR = 0.22, 95% CI = 0.15 ~ 0.31, p < 0.0001) and hospitalisation expenses (SMD = -0.53, 95% CI = -0.78 ~ -0.28, p < 0.0001). The patient satisfaction was significantly improved (odds ratio = 8.11, 95% CI = 4.96 ~ 13.24, p < 0.0001), and there were no significant differences in intraoperative blood loss and operation time between the two groups.

The application of the ERAS protocol in gynaecological surgery significantly improves the effectiveness and safety of the procedure. Thus, it can be promoted and applied in clinical practice in China.