| Enhanced recovery in colorectal resections: a systematic review and meta-analysis. | |
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MedLine Citation:
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PMID: 19207699 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The study aimed to produce a comprehensive up-to-date meta-analysis exploring the safety and efficacy of enhanced recovery (ER) programmes after colorectal resection. METHOD: Key-word and MESH-heading searches of MEDLINE, EMBASE and the Cochrane Databases from 1966 to February 2007 were used to identify all available randomized and clinical controlled studies. Two independent reviewers assessed studies for inclusion and exclusion based on methodological quality criteria prior to undertaking data extraction. Summary estimates of treatment effects using a fixed effect model were produced with RevMan 1.0.2, using weighted means for length-of-stay data and relative risks of morbidity, mortality and readmission rates. RESULTS: Analysis of four papers including 376 patients demonstrated primary and total length-of-stays (primary + readmission length-of-stay) to be significantly reduced (P < 0.001) with ER programmes [weighted mean differences of -3.64 days (95% confidence interval, 95% CI -4.98 to -2.29) and -3.75 days (95% CI-5.11 to -2.40)]. Analysis of controlled clinical trial data showed morbidity rates to be reduced and readmission rates increased. These trends were not seen amongst the randomized controlled trial data. There were no differences in mortality rates. CONCLUSION: Enhanced recovery programmes after colorectal resections reduce length-of-stay and may reduce 30 days morbidity and increase 30 days readmission without increasing mortality. |
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Authors:
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C J Walter; J Collin; J C Dumville; P J Drew; J R Monson |
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Publication Detail:
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Type: Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review Date: 2009-02-04 |
Journal Detail:
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Title: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland Volume: 11 ISSN: 1463-1318 ISO Abbreviation: Colorectal Dis Publication Date: 2009 May |
Date Detail:
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Created Date: 2009-05-06 Completed Date: 2009-07-22 Revised Date: 2010-07-28 |
Medline Journal Info:
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Nlm Unique ID: 100883611 Medline TA: Colorectal Dis Country: England |
Other Details:
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Languages: eng Pagination: 344-53 Citation Subset: IM |
Affiliation:
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Academic Surgical Unit, The University of Hull, Castle Hill Hospital, Cottingham, Hull, UK. katiewaltersouthafrica@googlemail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Colectomy
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rehabilitation* Humans Length of Stay* Outcome Assessment (Health Care) Patient Readmission Postoperative Care / methods* Preoperative Care / methods* |
| Comments/Corrections | |
Erratum In:
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Colorectal Dis. 2010 Jul;12(7):728 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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