胃切除术后改善康复:更新了27项随机试验 (2018-2025) 的分析
Wei Liu1, Lihuang He2, Chaoli Yin3
1Department of Gastrointestinal Surgery ward 1, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, 150080, China.
BMC surgery
|December 7, 2025
概括
手术后增强恢复 (ERAS) 计划显著加速恢复,并降低了经过胃切除术的胃癌患者的成本. 有证据表明,ERAS可能会降低并发症而不会增加再录取,尽管确定性是中等的.
科学领域:
- 在瘤学瘤学.
- 手术创新 在外科创新.
- 基于证据的医学基于证据的医学.
背景情况:
- 手术后增强恢复 (ERAS) 计划在上胃肠道手术中越来越受欢迎.
- 在胃切除术中使用ERAS的证据,特别是最小侵入性和机器人方法,仍在不断发展.
- 这项研究旨在重新评估ERAS关于胃切除术结果的随机证据.
研究的目的:
- 系统地审查和分析随机对照试验 (RCT),将ERAS计划与胃切除患者的传统护理进行比较.
- 评估ERAS对住院时间,胃肠道恢复,并发症,再入院,死亡率和成本的影响.
- 在胃癌手术中提供基于证据的ERAS有效性的最新估计.
主要方法:
- 在主要数据库 (PubMed,Embase,Web of Science,Cochrane CENTRAL) 的系统文献搜索从2018年到2025年.
- 纳入并行组RCT,比较全途径ERAS与胃癌患者胃切除术的传统护理.
- 主要 (逗留时间) 和次要结果的随机效应元分析,通过GRADE评估证据的确定性.
主要成果:
- 包括27项试验,包括3274名患者.
- 埃拉斯显著减少了逗留时间,加速了胃肠道的恢复.
- 在敏感性分析中,ERAS显示总体并发症减少的趋势 (RR 0.73),显著;在特定并发症或再录取方面没有明显的差异.
结论:
- 在胃癌胃切除术中实施ERAS似乎可以改善术后恢复并降低成本.
- 埃拉斯似乎没有提高并发症或再接收率.
- 标准化的ERAS协议和报告对于提高可靠性和促进更广泛的临床采用至关重要.
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