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

Objectives: 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. Material and methods: 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. Results: 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 similar to -1.30, p < 0.0001), postoperative ambulation time (SMD = -4.16, 95% CI = -5.12 similar to -3.20, p < 0.0001), postoperative feeding time (SMD = -7.36, 95% CI = -9.67 similar to -5.05, p < 0.0001), postoperative exhaust time (SMD = -2.59, 95% CI = -3.15 similar to -2.03, p < 0.0001), postoperative defecation time (SMD = -2.23, 95% CI = -2.88 similar to -1.57, p < 0.0001), postoperative morbidity (OR = 0.22, 95% CI = 0.15 similar to 0.31, p < 0.0001) and hospitalisation expenses (SMD = -0.53, 95% CI = -0.78 similar to -0.28, p < 0.0001). The patient satisfaction was significantly improved (odds ratio = 8.11, 95% CI = 4.96 similar to 13.24, p < 0.0001), and there were no significant differences in intraoperative blood loss and operation time between the two groups. Conclusions: 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.