Enhanced recovery after surgery programs versus traditional perioperative care in laparoscopic hepatectomy

Enhanced recovery after surgery programs versus traditional perioperative care in laparoscopic hepatectomy

Yang R, Tao W, Chen YY, Zhang BH, Tang JM, Zhong S, Chen XX. Enhanced recovery after surgery programs versus traditional perioperative care in laparoscopic hepatectomy: A meta-analysis. Int J Surg. 2016 Dec;36(Pt A):274-282.

What is already known:

Multiple published trials, including a recent meta-analysis (Song et al 2016) have highlighted the benefits of implementing ERAS programs in patients undergoing open hepatectomy. However, with an increasing number of centers now moving towards a laparoscopic approach the evidence for using such programs within this cohort is less well established.

What this paper adds:

This meta-analysis, which includes 8 studies (3RCT and 5CCT), showed no significant difference when applying ERAS principles to intra-operative complications including blood loss, blood transfusion requirement and intra-operative surgical time. There was however a significant improvement in post-operative recovery with a reduced time to first oral intake, flatus and a decreased post-operative stay and complication rate. Re-admission rates were not analysed due to the lack of data in the reviewed studies and variance in study protocols.

Further studies may be required to determine the optimal ERAS protocol for patients undergoing a laparoscopic hepatectomy.

Emma Stewart, Guildford.