Clinical efficacy of enhanced recovery after surgery (ERAS) program in patients undergoing radical prostatectomy: a systematic review and meta-analysis

Yurong Zhao, Shaobo Zhang, Bianjiang Liu, Jie Li, Hanxia Hong, Yurong Zhao, Shaobo Zhang, Bianjiang Liu, Jie Li, Hanxia Hong

Abstract

Background: Enhanced recovery after surgery (ERAS) protocol has been identified to be beneficial in the amount of operations such as gastrointestinal surgery. However, the efficacy and safety in robot-assisted laparoscopic prostatectomy/laparoscopic radical prostatectomy (RALP/LRP) still remain controversial.

Method: We searched randomized controlled trials and retrospective cohort studies comparing ERAS versus conventional care for prostate cancer patients who have undergone RALP/LRP. ERAS-related data were extracted, and quality of included studies was assessed using the Newcastle-Ottawa quality assessment scale and the Jadad scale.

Result: As a result, seven trials containing 784 prostate cancer patients were included. ERAS was observed to be significantly associated with shorter length of hospital stay (SMD - 2.55, 95%CI - 3.32 to - 1.78, P < 0.05), shorter time to flatus (SMD - 1.55, 95%CI - 2.26 to - 0.84, P < 0.05), shorter time to ambulate (SMD - 6.50, 95%CI - 10.91 to - 2.09, P < 0.05), shorter time to defecate (SMD - 2.80, 95%CI - 4.56 to - 1.04, P < 0.05), and shorter time to remove drainage tube (SMD - 2.72, 95%CI - 5.31 to - 0.12, P < 0.05). Otherwise, no significant difference was reported in other measurements.

Conclusions: In conclusion, ERAS can reduce length of hospital stay, time to flatus, time to defecate, time to ambulate, and time to remove drainage tube in prostate cancer patients who have undergone RALP/LRP compared with conventional care.

Keywords: Enhanced recovery after surgery; Meta-analysis; Radical prostatectomy; Systematic review.

Conflict of interest statement

No competing interest exists in this manuscript.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection in the systematic review and meta-analysis
Fig. 2
Fig. 2
Results of meta-analysis for enhanced recovery after surgery (ERAS) in patients undergoing radical prostatectomy, including the length of hospital stay (a), time to ambulate (b), time to flatus (c), time to defecate (d), and time to remove drainage tubes (e)

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Source: PubMed

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